Cuspidi Cesare, Sala Carla, Tadic Marijana, Gherbesi Elisa, De Giorgi Antonio, Grassi Guido, Mancia Giuseppe
Department of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy.
Istituto Auxologico Italiano, Milano, Italy.
J Clin Hypertens (Greenwich). 2017 Jul;19(7):713-721. doi: 10.1111/jch.13023.
Reverse or inverted dipping (ie, the phenomenon characterized by higher nighttime compared with daytime blood pressure values) is an alteration of circadian blood pressure rhythm frequently documented in hypertension, type 2 diabetes mellitus, chronic kidney disease, and sleep apnea syndrome, and generally regarded as a harmful condition. Available literature on the clinical and prognostic implications of reverse dipping is scanty. The present article will review a number of relevant issues concerning reverse dipping, in particular: (1) its possible mechanisms; (2) prevalence and clinical correlates, (3) concomitant cardiac and extracardiac subclinical organ damage; (4) association with acute and chronic cardiovascular diseases; (5) prognostic value in predicting cardiovascular events and mortality; and (6) therapeutic interventions aimed at reverting this abnormal circadian blood pressure rhythm.
反勺型或倒勺型血压（即夜间血压值高于白天血压值的现象）是昼夜血压节律的一种改变，在高血压、2型糖尿病、慢性肾脏病和睡眠呼吸暂停综合征中经常有记录，通常被认为是一种有害状态。关于反勺型血压的临床和预后意义的现有文献很少。本文将综述与反勺型血压相关的一些问题，特别是：（1）其可能的机制；（2）患病率及临床相关因素；（3）并发的心脏和心外亚临床器官损害；（4）与急性和慢性心血管疾病的关联；（5）预测心血管事件和死亡率的预后价值；以及（6）旨在恢复这种异常昼夜血压节律的治疗干预措施。
