Nocturnal blood pressure in untreated essential hypertensives

Cesare Cuspidi, Carla Sala, Cristiana Valerio, Francesca Negri, Giuseppe Mancia

Research output: Contribution to journalArticle

Abstract

Aim. Prevalence, correlates and reproducibility of nocturnal hypertension (NH) as defined by fixed cut-off limits in uncomplicated essential hypertension are poorly defined. Therefore, we assessed such issue in a cohort of 658 untreated hypertensives. Methods. All subjects underwent procedures including cardiac and carotid ultrasonography, 24-h urine collection for microalbuminuria, ambulatory blood pressure monitoring (ABPM), over two 24-h periods within 4 weeks. NH was defined according to current guidelines (i.e. night-time blood pressure, BP ≥ 120/70 mmHg) and non-dipping status as a reduction in average systolic (SBP) and diastolic BP (DBP) at night lower than 10% compared with daytime values. Results. A total of 477 subjects showed NH during the first and second ABPM period; 62 subjects had normal nocturnal BP (NN) in both ABPM sessions. Finally, 119 subjects changed their pattern from one ABPM session to the other. Overall, 72.5% of subjects had reproducible NH, 18% variable pattern (VP) and 9.5% reproducible NN. In the same group, figures of reproducible non-dipping, variable dipping and reproducible dipping pattern were 24%, 24% and 52%, respectively. Among NH patients, 56% of whom were dippers, subclinical cardiac organ damage was more pronounced than in their NN counterparts. Conclusions. In uncomplicated essential hypertensives, NH is a more frequent pattern than non-dipping; NH is associated with organ damage, independently of dipping/non-dipping status. This suggests that options aimed at restoring a blunted nocturnal BP fall may be insufficient to prevent cardiovascular complications unless night-time BP values are fully normalized

Original languageEnglish
Pages (from-to)335-341
Number of pages7
JournalBlood Pressure
Volume20
Issue number6
DOIs
Publication statusPublished - Dec 2011

Fingerprint

Ambulatory Blood Pressure Monitoring
Blood Pressure
Hypertension
Urine Specimen Collection
Ultrasonography
Guidelines

Keywords

  • nocturnal hypertension
  • non-dipping
  • organ damage

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Nocturnal blood pressure in untreated essential hypertensives. / Cuspidi, Cesare; Sala, Carla; Valerio, Cristiana; Negri, Francesca; Mancia, Giuseppe.

In: Blood Pressure, Vol. 20, No. 6, 12.2011, p. 335-341.

Research output: Contribution to journalArticle

Cuspidi, Cesare ; Sala, Carla ; Valerio, Cristiana ; Negri, Francesca ; Mancia, Giuseppe. / Nocturnal blood pressure in untreated essential hypertensives. In: Blood Pressure. 2011 ; Vol. 20, No. 6. pp. 335-341.
@article{31ef7724e14944c2b69dc557cb2699ed,
title = "Nocturnal blood pressure in untreated essential hypertensives",
abstract = "Aim. Prevalence, correlates and reproducibility of nocturnal hypertension (NH) as defined by fixed cut-off limits in uncomplicated essential hypertension are poorly defined. Therefore, we assessed such issue in a cohort of 658 untreated hypertensives. Methods. All subjects underwent procedures including cardiac and carotid ultrasonography, 24-h urine collection for microalbuminuria, ambulatory blood pressure monitoring (ABPM), over two 24-h periods within 4 weeks. NH was defined according to current guidelines (i.e. night-time blood pressure, BP ≥ 120/70 mmHg) and non-dipping status as a reduction in average systolic (SBP) and diastolic BP (DBP) at night lower than 10{\%} compared with daytime values. Results. A total of 477 subjects showed NH during the first and second ABPM period; 62 subjects had normal nocturnal BP (NN) in both ABPM sessions. Finally, 119 subjects changed their pattern from one ABPM session to the other. Overall, 72.5{\%} of subjects had reproducible NH, 18{\%} variable pattern (VP) and 9.5{\%} reproducible NN. In the same group, figures of reproducible non-dipping, variable dipping and reproducible dipping pattern were 24{\%}, 24{\%} and 52{\%}, respectively. Among NH patients, 56{\%} of whom were dippers, subclinical cardiac organ damage was more pronounced than in their NN counterparts. Conclusions. In uncomplicated essential hypertensives, NH is a more frequent pattern than non-dipping; NH is associated with organ damage, independently of dipping/non-dipping status. This suggests that options aimed at restoring a blunted nocturnal BP fall may be insufficient to prevent cardiovascular complications unless night-time BP values are fully normalized",
keywords = "nocturnal hypertension, non-dipping, organ damage",
author = "Cesare Cuspidi and Carla Sala and Cristiana Valerio and Francesca Negri and Giuseppe Mancia",
year = "2011",
month = "12",
doi = "10.3109/08037051.2011.587280",
language = "English",
volume = "20",
pages = "335--341",
journal = "Blood Pressure",
issn = "0803-7051",
publisher = "Informa Healthcare",
number = "6",

}

TY - JOUR

T1 - Nocturnal blood pressure in untreated essential hypertensives

AU - Cuspidi, Cesare

AU - Sala, Carla

AU - Valerio, Cristiana

AU - Negri, Francesca

AU - Mancia, Giuseppe

PY - 2011/12

Y1 - 2011/12

N2 - Aim. Prevalence, correlates and reproducibility of nocturnal hypertension (NH) as defined by fixed cut-off limits in uncomplicated essential hypertension are poorly defined. Therefore, we assessed such issue in a cohort of 658 untreated hypertensives. Methods. All subjects underwent procedures including cardiac and carotid ultrasonography, 24-h urine collection for microalbuminuria, ambulatory blood pressure monitoring (ABPM), over two 24-h periods within 4 weeks. NH was defined according to current guidelines (i.e. night-time blood pressure, BP ≥ 120/70 mmHg) and non-dipping status as a reduction in average systolic (SBP) and diastolic BP (DBP) at night lower than 10% compared with daytime values. Results. A total of 477 subjects showed NH during the first and second ABPM period; 62 subjects had normal nocturnal BP (NN) in both ABPM sessions. Finally, 119 subjects changed their pattern from one ABPM session to the other. Overall, 72.5% of subjects had reproducible NH, 18% variable pattern (VP) and 9.5% reproducible NN. In the same group, figures of reproducible non-dipping, variable dipping and reproducible dipping pattern were 24%, 24% and 52%, respectively. Among NH patients, 56% of whom were dippers, subclinical cardiac organ damage was more pronounced than in their NN counterparts. Conclusions. In uncomplicated essential hypertensives, NH is a more frequent pattern than non-dipping; NH is associated with organ damage, independently of dipping/non-dipping status. This suggests that options aimed at restoring a blunted nocturnal BP fall may be insufficient to prevent cardiovascular complications unless night-time BP values are fully normalized

AB - Aim. Prevalence, correlates and reproducibility of nocturnal hypertension (NH) as defined by fixed cut-off limits in uncomplicated essential hypertension are poorly defined. Therefore, we assessed such issue in a cohort of 658 untreated hypertensives. Methods. All subjects underwent procedures including cardiac and carotid ultrasonography, 24-h urine collection for microalbuminuria, ambulatory blood pressure monitoring (ABPM), over two 24-h periods within 4 weeks. NH was defined according to current guidelines (i.e. night-time blood pressure, BP ≥ 120/70 mmHg) and non-dipping status as a reduction in average systolic (SBP) and diastolic BP (DBP) at night lower than 10% compared with daytime values. Results. A total of 477 subjects showed NH during the first and second ABPM period; 62 subjects had normal nocturnal BP (NN) in both ABPM sessions. Finally, 119 subjects changed their pattern from one ABPM session to the other. Overall, 72.5% of subjects had reproducible NH, 18% variable pattern (VP) and 9.5% reproducible NN. In the same group, figures of reproducible non-dipping, variable dipping and reproducible dipping pattern were 24%, 24% and 52%, respectively. Among NH patients, 56% of whom were dippers, subclinical cardiac organ damage was more pronounced than in their NN counterparts. Conclusions. In uncomplicated essential hypertensives, NH is a more frequent pattern than non-dipping; NH is associated with organ damage, independently of dipping/non-dipping status. This suggests that options aimed at restoring a blunted nocturnal BP fall may be insufficient to prevent cardiovascular complications unless night-time BP values are fully normalized

KW - nocturnal hypertension

KW - non-dipping

KW - organ damage

UR - http://www.scopus.com/inward/record.url?scp=81255124296&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=81255124296&partnerID=8YFLogxK

U2 - 10.3109/08037051.2011.587280

DO - 10.3109/08037051.2011.587280

M3 - Article

C2 - 21651423

AN - SCOPUS:81255124296

VL - 20

SP - 335

EP - 341

JO - Blood Pressure

JF - Blood Pressure

SN - 0803-7051

IS - 6

ER -