Adrenergic, metabolic, and reflex abnormalities in reverse and extreme dipper hypertensives

Guido Grassi, Gino Seravalle, Fosca Quarti-Trevano, Raffaella Dell'Oro, Michele Bombelli, Cesare Cuspidi, Rita Facchetti, Gianbattista Bolla, Giuseppe Mancia

Research output: Contribution to journalArticle


Limited information is available on whether and to what extent the different patterns of the nocturnal blood pressure profile reported in hypertension are characterized by differences in sympathetic drive that may relate to, and account for, the different day-night blood pressure changes. In 34 untreated middle-aged essential hypertensive dippers, 17 extreme dippers, 18 nondippers, and 10 reverse dippers, we assessed muscle sympathetic nerve traffic, heart rate, and beat-to-beat arterial blood pressure at rest and during baroreceptor deactivation and stimulation. Measurements were also performed in 17 age-matched dipper normotensives. All patients displayed reproducible blood pressure patterns at 2 different monitoring sessions. The 4 hypertensive groups did not differ by gender or 24-hour or daytime blood pressure. Muscle sympathetic nerve traffic was significantly higher in nondipper, dipper, and extreme dipper hypertensives than in normotensive controls (58.6 ± 1.8, 55.6 ± 0.9, and 53.3 ± 0.8 versus 43.5 ± 1.4 bursts/100 heartbeats, respectively; P

Original languageEnglish
Pages (from-to)925-931
Number of pages7
Issue number5
Publication statusPublished - Nov 2008


  • Ambulatory blood pressure
  • Baroreflex
  • Extreme dipping
  • Hypertension
  • Reverse dipping
  • Sympathetic activity

ASJC Scopus subject areas

  • Internal Medicine

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