Anyfanti Panagiota, Malliora Anastasia, Chionidou Agapi, Mastrogiannis Konstantinos, Lazaridis Antonios, Gkaliagkousi Eugenia
Second Medical Department, Hippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Curr Hypertens Rep. 2024 Feb;26(2):69-80. doi: 10.1007/s11906-023-01277-x. Epub 2023 Oct 31.
This narrative review article aims to discuss more recent evidence, current challenges, and future perspectives regarding the clinical importance of nocturnal hypertension and nighttime blood pressure dipping, with particular reference to diagnosis, prognostic value, and therapeutic approach.
The importance of nighttime blood pressure and nighttime blood pressure dipping has been demonstrated in decades. Increased nighttime blood pressure has been acknowledged as an unfavorable clinical trait. However, more recent evidence suggests that the abolishment of normal circadian blood pressure rhythm is not always a solid predictor of adverse cardiovascular events and needs to be interpreted in the light of each patients' individual characteristics. Physicians treating hypertensive patients with adverse nighttime blood pressure profiles often face the dilemma of chronotherapy. This has been a blurred field for years, yet very recent evidence from appropriately designed studies attempts to shed light on this puzzling question. As 24-h ambulatory blood pressure monitoring is being increasingly recommended and applied in real-world practice for the diagnosis and monitoring of hypertension, information on nighttime blood pressure and nocturnal dipping profile is collected but is not always easy to interpret.
本叙述性综述文章旨在讨论关于夜间高血压和夜间血压下降的临床重要性的最新证据、当前挑战及未来展望，尤其涉及诊断、预后价值和治疗方法。
夜间血压及夜间血压下降的重要性在过去几十年中已得到证实。夜间血压升高已被公认为是一种不良临床特征。然而，最新证据表明，正常昼夜血压节律的消失并不总是不良心血管事件的可靠预测指标，需要根据每个患者的个体特征进行解读。治疗夜间血压异常的高血压患者的医生常常面临时间治疗的困境。多年来这一直是个模糊的领域，但来自精心设计研究的最新证据试图阐明这个令人困惑的问题。随着24小时动态血压监测越来越多地被推荐并应用于临床实际中以诊断和监测高血压，关于夜间血压和夜间血压下降情况的信息被收集，但并不总是易于解读。
