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Non-dipping morning blood pressure and isolated systolic hypertension in elderly

M H Zain-El1, M Snincak, K Pahuli

  • 1Center for Research, Diagnosis and Treatment of Hypertension, Clinic of Geriatrics and Health Care School of Medical of Medicine, PJ Safarikiensis University, Kosice, Slovakia. mhzain@lf.upjs.sk

Bratislavske Lekarske Listy
|February 15, 2013
PubMed

Insights

An early morning blood pressure surge in treated elderly hypertensive patients predicts target organ damage. This finding is crucial for managing hypertension and preventing complications, regardless of dipping status.

Area of Science:

  • Cardiology
  • Nephrology
  • Endocrinology

Background:

  • Morning hypertension is a clinical challenge, often overlooked.
  • Home 24-hour blood pressure monitoring is recommended for high-risk patients.
  • Understanding early morning blood pressure surges is key to managing hypertension.

Purpose of the Study:

  • To investigate the association between early morning blood pressure surges and target organ damage in treated elderly hypertensive patients.
  • To determine if a single 24-hour blood pressure monitoring can identify increased risk.

Main Methods:

  • 310 treated hypertensive patients were studied.
  • Patients were categorized into systolic/diastolic hypertension and isolated systolic hypertension groups.
  • Blood pressure monitoring assessed early morning surges and dipping patterns.

Main Results:

  • Early morning surges were observed, particularly in female non-dippers.
  • Non-dippers showed higher rates of diabetes mellitus, renal insufficiency, and endocrine disorders.
  • Left ventricular hypertrophy was universal; heart failure, renal insufficiency, and retinopathy were more prevalent in non-dippers. Aortic aneurysms were exclusive to non-dippers.

Conclusions:

  • An early morning blood pressure surge is a significant predictor of hypertensive target organ damage.
  • Dipper or non-dipper status in isolated systolic hypertension may be less critical than the degree of target organ damage and diurnal variation.
Abstract

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