Antihypertensive therapy: nocturnal dippers and nondippers. Do we treat them differently?

Antihypertensive therapy: nocturnal dippers and nondippers. Do we treat them differently?

Por: Chakrapani Mahabala, Padmanabha Kamath, Unnikrishnan Bhaskaran, Narasimha D Pai y Aparna U Pai. DOVE MEDICAL March 2013, Volume 2013:9 Pages 125 – 133.

Hypertension is a major independent risk factor for cardiovascular diseases. Management of hypertension is generally based on office blood pressure since it is easy to determine. Since casual blood pressure readings in the office are influenced by various factors, they do not represent basal blood pressure. Dipping of the blood pressure in the night is a normal physiological change that can be blunted by cardiovascular risk factors and the severity of hypertension. Nondipping pattern is associated with disease severity, left ventricular hypertrophy, increased proteinuria, secondary forms of hypertension, increased insulin resistance, and increased fibrinogen level. Long-term observational studies have documented increased cardiovascular events in patients with nondipping patterns.   [Actualizado: 25 de abril 2013]