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Dippers versus non-dippers.

P Verdecchia1, G Schillaci, C Porcellati

  • 1R. Silvestrini General Hospital, Division of Medicine, Perugia, Italy.

Journal of Hypertension. Supplement : Official Journal of the International Society of Hypertension
|December 1, 1991
PubMed
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Essential hypertension patients with a flattened 24-hour blood pressure profile (non-dippers) face increased cardiovascular risks. This classification, based on a less than 10% nocturnal blood pressure dip, affects approximately 35% of essential hypertension patients.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Clinical Physiology

Background:

  • Essential hypertension is linked to cardiovascular complications like stroke and left ventricular hypertrophy.
  • Patient outcomes are influenced by 24-hour blood pressure variability, specifically the day-night dipping pattern.
  • Non-invasive ambulatory blood pressure monitoring (ABPM) is crucial for assessing this variability.

Purpose of the Study:

  • To investigate the prevalence and clinical significance of the dipper and non-dipper classification in essential hypertension.
  • To explore the relationship between blood pressure dipping status and cardiovascular complications, particularly left ventricular hypertrophy.
  • To evaluate the impact of defining daytime and night-time hours on patient classification.

Main Methods:

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  • Utilized non-invasive ambulatory blood pressure monitoring (ABPM) in a cohort of essential hypertension patients.
  • Defined daytime as 0600-2200 h and night-time as 2200-0600 h.
  • Classified patients as non-dippers if nocturnal systolic and diastolic blood pressure reduction was less than 10% of daytime levels.

Main Results:

  • Approximately 35% of essential hypertension patients were classified as non-dippers based on the defined criteria.
  • Non-dipper status was associated with greater left ventricular mass in women, but not in men.
  • Sleep monitoring indicated no significant disturbance affecting day-night blood pressure differences.

Conclusions:

  • The non-dipper classification is prevalent in essential hypertension and may indicate increased cardiovascular risk, particularly left ventricular hypertrophy in women.
  • Further research is needed to clarify the clinical significance of dipper/non-dipper status for risk stratification in hypertensive patients.
  • Standardized definitions for diurnal blood pressure variation are essential for consistent patient classification and risk assessment.