Non-Dipping Blood Pressure or Nocturnal Hypertension: Does One Matter More?

Curr Hypertens Rep. 2024 Jan;26(1):21-30. doi: 10.1007/s11906-023-01273-1. Epub 2023 Nov 13.

Abstract

Purpose of review: Nocturnal hypertension and non-dipping are both associated with increased cardiovascular risk; however, debate remains over which is a better prognosticator of cardiovascular outcomes. This review explores current literature on nocturnal hypertension and non-dipping to assess their relationship to cardiovascular disease and implications for clinical practice.

Recent findings: While current data remain inconclusive, some suggest that nocturnal hypertension is a more reliable and clinically significant marker of cardiovascular risk than non-dipping status. Importantly, reducing nocturnal HTN and non-dipping through chronotherapy, specifically evening dosing of antihypertensives, has not been conclusively shown to provide long-term cardiovascular benefits. Recent data suggests that non-dipping, compared to nocturnal hypertension, may be falling out of favor as a prognostic indicator for adverse cardiovascular outcomes. However, additional information is needed to understand how aberrant nighttime blood pressure patterns modulate cardiovascular risk to guide clinical management.

Keywords: Ambulatory blood pressure monitoring; Nocturnal hypertension; Non-dipping.

Publication types

  • Review

MeSH terms

  • Antihypertensive Agents / pharmacology
  • Blood Pressure / physiology
  • Blood Pressure Monitoring, Ambulatory
  • Circadian Rhythm
  • Humans
  • Hypertension*

Substances

  • Antihypertensive Agents