[Ambulatory blood pressure in the elderly with hypertension]

Because the arterial baroreceptor reflex function that modulates the variability of blood pressure decline with advancing age, blood pressure in the elderly is more variable than in young patients. Recent advances in ambulatory blood pressure monitoring devices clarified the changes in the blood pressures in daily life which had been never observed by the office blood pressure measurement. 1. White coat hypertension: Temporary elevation of blood pressure in the clinic is referred as a white coat hypertension and there is much recent evidence indicating that it is common in the elderly. Our recent data indicated that left ventricular mass in patients with white coat hypertension is higher than that in the normotensive groups, although it is lower than that in the true persistent hypertensive group. This suggests that white coat hypertension is never innocent and should be treated by a mild antihypertensive drug. 2. Morning surge: Many reports indicate that cardiovascular events occur more frequently in the early morning, suggesting a morning rise in blood pressure might be associated with this catastrophe. Using an activetrace that assesses physical activity objectively, we recently clarified that morning surge can be divided into two types. One is morning rise which begins in accordance with awakening and arising. The other is a rise during sleep before awakening. 3. Although blood pressure rises during the daytime and decreases at nighttime in healthy individuals, recent reports indicate that there are many conditions in which blood pressure does not fall at night. Individuals with this condition have been called non-dippers and tend to be associated with hypertensive target-organ damage such as silent stroke or Binswanger's dementia.(ABSTRACT TRUNCATED AT 250 WORDS)