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Nocturnal non-dipping pattern in untreated hypertensives at different cardiovascular risk according to the 2003

Cesare Cuspidi1, Stefano Meani, Cristiana Valerio

  • 1Istituto di Medicina Cardiovascolare, Università di Milano, and Centro Interuniversitario di Fisiologia Clinica e Ipertensione, Ospedale Maggiore Policlinico IRCCS, Milano, Italy. dhipertensione@libero.it

Blood Pressure
|February 24, 2006
PubMed

Insights

Essential hypertension patients with a non-dipping blood pressure pattern have a higher cardiovascular risk. This nocturnal blood pressure alteration is more prevalent in high-risk individuals, indicating increased cardiovascular risk.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Preventive Medicine

Background:

  • Essential hypertension affects a large population globally.
  • Nocturnal blood pressure (BP) patterns, specifically the non-dipping phenomenon, are increasingly recognized as significant indicators of cardiovascular risk.
  • Understanding the link between non-dipping BP and overall cardiovascular risk is crucial for effective patient stratification and management.

Purpose of the Study:

  • To investigate the relationship between the non-dipping blood pressure (BP) pattern and total cardiovascular risk in a large cohort of untreated, uncomplicated essential hypertensive patients.
  • To determine the prevalence of the non-dipping BP pattern across different cardiovascular risk strata.

Main Methods:

  • A cohort of 580 patients with grade 1 or 2 essential hypertension underwent comprehensive cardiovascular risk assessment.
  • Methods included 24-hour ambulatory BP monitoring, microalbuminuria assessment, echocardiography, and carotid ultrasonography.
  • Cardiovascular risk was stratified using the 2003 European Society of Hypertension/European Society of Cardiology guidelines.

Main Results:

  • The prevalence of the non-dipping BP pattern (nighttime BP decrease ≤10% of daytime values) was significantly higher in high-risk patients (42.2%) compared to medium-risk (32.6%) and low-risk (28.5%) patients.
  • Target organ damage (TOD) was present in 38.5% of the overall population, contributing to high-risk classification.
  • The non-dipping pattern was more frequent in patients with existing target organ damage or multiple risk factors.

Conclusions:

  • The non-dipping blood pressure profile is significantly more prevalent in high-risk essential hypertensive patients.
  • This finding highlights the non-dipping pattern as a valuable marker for identifying individuals with elevated cardiovascular risk.
  • Early identification of the non-dipping pattern can aid in risk stratification and guide therapeutic interventions in hypertension management.
Abstract

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