TY - JOUR
T1 - Clinical significance of nocturnal blood pressure monitoring
AU - Imai, Yutaka
AU - Ohkubo, Takayoshi
AU - Tsuji, Ichiro
AU - Satoh, Hiroshi
AU - Hisamichi, Shigeru
N1 - Funding Information:
This work was supported by Research Grant from Takeda Medical Foundation (1996 and 1997), by Research Grant from Mistui Life Social Welfare Foundation (1998), by Research Grant entitled “Evaluation of the effect of drug treatment on hypertension and other chronic disease conditions in the elderly” ( 1995 and 1996), Kenko-Seisaku Chosa Ken Kyu (1 996, 1997 and 1998), Roj in Hoken Jigyo Suishin Hojokin (1998), from the Ministry of Health and Welfare, and by Research Grant from Scientific Research (1 0470 102) from the Ministry of Education, Science and Culture of Japan
PY - 1999
Y1 - 1999
N2 - Although there are certain technical problems in determining nocturnal BP by ambulatory BP monitoring, the information provided on nocturnal BP has possible clinical significance. Short-term BP variability, an elevated BP during sleep and amplitude and sleep of nocturnal BP decline might be responsible for cardiovascular mortality. Furthermore, circadian BP variation might also be responsible for cardiovascular morbidity and mortality. The nocturnal BP level, even in extreme dippers with diurnal hypertension, is equivalent to or higher than that in normotensive subjects. Antihypertensive effects of drugs with different pharmacologic properties positively correlate with basal ambulatory BP. Therefore, there is a critical BP level at which the antihypertensive effect disappears. The critical BP level for each drug is in normal BP range but not in the hypotensive range. Therefore, an antihypertensive regimen would be safe even in extreme-dipper hypertension without excessive nocturnal hypotension, and might even be beneficial because of the decreasing amplitude and speed of the nocturnal BP decline. We conclude that an antihypertensive drug regimen should control BP throughout a 24-h period regardless of circadian BP variation.
AB - Although there are certain technical problems in determining nocturnal BP by ambulatory BP monitoring, the information provided on nocturnal BP has possible clinical significance. Short-term BP variability, an elevated BP during sleep and amplitude and sleep of nocturnal BP decline might be responsible for cardiovascular mortality. Furthermore, circadian BP variation might also be responsible for cardiovascular morbidity and mortality. The nocturnal BP level, even in extreme dippers with diurnal hypertension, is equivalent to or higher than that in normotensive subjects. Antihypertensive effects of drugs with different pharmacologic properties positively correlate with basal ambulatory BP. Therefore, there is a critical BP level at which the antihypertensive effect disappears. The critical BP level for each drug is in normal BP range but not in the hypotensive range. Therefore, an antihypertensive regimen would be safe even in extreme-dipper hypertension without excessive nocturnal hypotension, and might even be beneficial because of the decreasing amplitude and speed of the nocturnal BP decline. We conclude that an antihypertensive drug regimen should control BP throughout a 24-h period regardless of circadian BP variation.
KW - Ambulatory blood pressure
KW - Antihypertensive treatment
KW - Circadian variation
KW - Nocturnal blood pressure
KW - Short-term variability
UR - http://www.scopus.com/inward/record.url?scp=0032769475&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0032769475&partnerID=8YFLogxK
U2 - 10.3109/10641969909061002
DO - 10.3109/10641969909061002
M3 - Article
C2 - 10423095
AN - SCOPUS:0032769475
VL - 21
SP - 717
EP - 727
JO - Clinical and Experimental Hypertension
JF - Clinical and Experimental Hypertension
SN - 1064-1963
IS - 5-6
ER -