Ambulatory blood pressure monitoring (ABPM), in addition to office and home BP measurement, plays a central role in discriminating high-risk BP phenotypes such as sustained, masked, and nocturnal hypertension (NH) from low-risk phenotypes (i.e., true normotension, isolated clinic hypertension). The assessment of 24-h BP profile in clinical practice overcomes the limitations of office and home BP measurements and in particular provides reliable information on BP load during daily life as nighttime rest. Several lines of evidence from cross-sectional and longitudinal studies point to nighttime BP as a powerful risk factor for subclinical organ damage, cardiovascular events, and all-cause mortality. Searching for NH is increasingly regarded as an effective diagnostic strategy to improve cardiovascular risk stratification in the hypertensive setting and optimize therapeutic strategies. This chapter will focus on the relationship between NH, organ damage, and cardiovascular prognosis. The therapeutic approach to this condition based on available evidence will also be discussed
Cuspidi, C., Sala, C., Tadic, M., Grassi, G. (2018). Nocturnal Hypertension. In A.E. Berbari, Mancia G (a cura di), Disorders of Blood Pressure Regulation Phenotypes, Mechanisms, Therapeutic Options (pp. 663-673). Springer International Publishing AG [10.1007/978-3-319-59918-2_39].
Nocturnal Hypertension
Cuspidi, C;Grassi, G
2018
Abstract
Ambulatory blood pressure monitoring (ABPM), in addition to office and home BP measurement, plays a central role in discriminating high-risk BP phenotypes such as sustained, masked, and nocturnal hypertension (NH) from low-risk phenotypes (i.e., true normotension, isolated clinic hypertension). The assessment of 24-h BP profile in clinical practice overcomes the limitations of office and home BP measurements and in particular provides reliable information on BP load during daily life as nighttime rest. Several lines of evidence from cross-sectional and longitudinal studies point to nighttime BP as a powerful risk factor for subclinical organ damage, cardiovascular events, and all-cause mortality. Searching for NH is increasingly regarded as an effective diagnostic strategy to improve cardiovascular risk stratification in the hypertensive setting and optimize therapeutic strategies. This chapter will focus on the relationship between NH, organ damage, and cardiovascular prognosis. The therapeutic approach to this condition based on available evidence will also be discussed
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