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[Diagnostic significance of absent nocturnal blood pressure decrease in 24-hour long-term blood pressure measurement]
J Schrader1, G Schoel, S Lüders
1Abt. Nephrologie/Rheumatologie, Med. Univ.-Klinik Göttingen.
Zeitschrift Fur Kardiologie
|January 1, 1992
Summary
Patients with essential hypertension typically show a nocturnal blood pressure (BP) decrease. A lack of this nighttime BP decline in 24-h monitoring suggests secondary hypertension and warrants further investigation.
Area of Science:
- Nephrology
- Cardiology
- Hypertension Research
Context:
- Essential hypertension usually features a normal diurnal blood pressure (BP) variation with a nocturnal decrease.
- Secondary hypertension often lacks this typical nocturnal BP reduction pattern.
Purpose:
- To assess the diagnostic value of nocturnal BP decrease in differentiating essential from secondary hypertension.
- To evaluate 24-hour ambulatory BP monitoring for identifying secondary hypertension.
Summary:
- Essential hypertension patients exhibited a mean nocturnal BP decrease of 22/17 mmHg.
- Secondary hypertension patients showed a significantly blunted nocturnal BP decrease (5.7/5.2 mmHg).
- A lack of nocturnal BP decline was observed in 69.8% of secondary hypertension cases versus 5.2% of essential hypertension cases.
Impact:
- Absence of nocturnal BP decline during ambulatory monitoring is a strong indicator of secondary hypertension.
- Identifying secondary hypertension early can guide further investigations and management.
- Nocturnal hypertension is linked to an increased risk of complications.