del Arco-Galán C, Suárez Fernández C
Servicio de Medicina Interna, Hospital de la Princesa, Universidad Autónoma, Madrid.
Med Clin (Barc). 1994 Apr 30;102(16):616-8.
The interpretation of the absence of a nocturnal fall in blood pressure (BP) (non-dipper condition) and its possible prognostic value are not clear. One possible hypothesis to be analyzed is whether the condition of non-dipper is due or not to the daily activity.
Ninety-five doctors, 47 of whom were females, whose age ranged between 24 and 46 years participated in the study. Ambulatory monitoring BP were programmed to be randomly carried out on-call and on a day-off with measurements intervals of 15 min. Mean systolic BP (SBP), diastolic BP (DBP) and heart rate (HR) were considered as measurement parameters for every period: 24 h, awake and sleep. Sleep period was considered as one of no less than 2 hours, nocturnal BP fall was defined as the difference between awake and sleep means, and dipper condition as a systolic decrease greater than 10 mmHg and diastolic decrease greater than 5 mmHg.
The mean nocturnal BP fall on the day-off was of 15% and 13% (SBP and DBP) and while on-call it was 18% and 15% respectively (p < 0.001). In absolute values the SBP decreased 21 +/- 10 mmHg and 18 +/- 10 mmHg and the DBP 11 +/- 6 mmHg and 10 +/- 5 mmHg, on-call and day off respectively (p < 0.001). The percentage of subjects with decrease lower than 10/5 mmHg was different in each of the two days (8% and 12%), however only one individual maintained the non-dipper condition in both period, although he reported many interruptions in the sleep. No association was established between the nocturnal BP fall and other variables (age, sex or family history of hypertension).
The non-dipper condition is changeable and is related to the activity carried out by the subject while awake, as well as the quality of sleep. It does not seem to be associated with inherent variables of the individual such as family history of hypertension, age or sex.
夜间血压（BP）无下降（非勺型状态）的解读及其可能的预后价值尚不清楚。一个有待分析的可能假设是，非勺型状态是否归因于日常活动。
95名医生参与了该研究，其中47名女性，年龄在24至46岁之间。动态血压监测被安排在随叫随到和休息日随机进行，测量间隔为15分钟。每个时间段（24小时、清醒和睡眠）的平均收缩压（SBP）、舒张压（DBP）和心率（HR）被视为测量参数。睡眠期被认为不少于2小时，夜间血压下降定义为清醒和睡眠平均值之间的差值，勺型状态定义为收缩压下降大于10 mmHg且舒张压下降大于5 mmHg。
休息日夜间血压平均下降幅度分别为15%和13%（SBP和DBP），而随叫随到日分别为18%和15%（p < 0.001）。绝对值方面，随叫随到日和休息日SBP分别下降21 +/- 10 mmHg和18 +/- 10 mmHg，DBP分别下降11 +/- 6 mmHg和10 +/- 5 mmHg（p < 0.001）。两天中收缩压和舒张压下降幅度低于10/5 mmHg的受试者百分比不同（8%和12%），然而，只有一名个体在两个时间段均维持非勺型状态，尽管他报告睡眠中有许多中断情况。夜间血压下降与其他变量（年龄、性别或高血压家族史）之间未建立关联。
非勺型状态是可变的，与受试者清醒时进行的活动以及睡眠质量有关。它似乎与个体的固有变量如高血压家族史、年龄或性别无关。
