Diminished circadian blood pressure rhythm in patients with asymptomatic normotensive pheochromocytoma.

In our study, the circadian blood pressure (BP) rhythm was studied in subjects with asymptomatic and normotensive pheochromocytoma. We have therefore performed 24-hour BP monitoring not only in 6 subjects with asymptomatic pheochromocytoma, but also in 33 patients with symptomatic pheochromocytoma and in 10 normotensive subjects, who served as a control group. Circadian BP rhythm was expressed by assessing a relative night-time BP decline. We found a similar BP rhythm, catecholamine excretion and tumor size in subjects with both forms of pheochromocytoma. Subjects with asymptomatic pheochromocytoma had a significantly lower night-time systolic BP decline (P=0.01) and diastolic BP decline (P=0.006) than normotensive controls. We conclude that the attenuated night-time BP decline in normotensive and asymptomatic subjects with pheochromocytoma might be a possible sign of partial desensitization of the cardiovascular system to catecholamines.