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Vol 20, No 2 (2016)
STATE-OF-THE ART REVIEW
Published online: 2016-06-30
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The current state of knowledge about the dipping and non-dipping hypertension

Zbigniew Dubielski, Michał Zamojski, Bartosz Wiechecki, Olga Możeńska, Monika Petelczyc, Dariusz Artur Kosior
DOI: 10.5603/AH.2016.0007
·
Arterial Hypertension 2016;20(2):33-43.

open access

Vol 20, No 2 (2016)
STATE-OF-THE ART REVIEW
Published online: 2016-06-30

Abstract

Ambulatory blood pressure monitoring provides information about the day-night blood pressure profile, which can be divided into dipping and non-dipping pattern. Non-dipping hypertension is recently thought to have increased cardiovascular risk and outcomes than dipping hypertension. The dipping pattern is explained by physiological changes in circadian rhythm, while the pathomechanism of non-dipping hypertension is not fully understood. Is it considered to be a result of many factors, such as: sympathetic nervous system overactivation, which can be accompanied by impaired parasympathetic nervous system response, obesity, concurrent diabetes mellitus and metabolic syndrome. Moreover abnormalities of hormones levels such as melatonin, catecholamines, thyroid and parathyroid hormones are connected to occurrence of non-dipping hypertension. Other widely discussed problem is obstructive sleep apnoea and its influence on circadian rhythm changes. Also dysfunction in activity of renin-angiotensin-aldosterone axis is thought to cause non-dipping pattern. There are some studies that indicate on role of inappropriate sodium intake in mentioned pathology. The chronic kidney disease and relationship with non-dipping hypertension will be also described. The last considered factor is influence of age on the development of non-dipping hypertension.

Abstract

Ambulatory blood pressure monitoring provides information about the day-night blood pressure profile, which can be divided into dipping and non-dipping pattern. Non-dipping hypertension is recently thought to have increased cardiovascular risk and outcomes than dipping hypertension. The dipping pattern is explained by physiological changes in circadian rhythm, while the pathomechanism of non-dipping hypertension is not fully understood. Is it considered to be a result of many factors, such as: sympathetic nervous system overactivation, which can be accompanied by impaired parasympathetic nervous system response, obesity, concurrent diabetes mellitus and metabolic syndrome. Moreover abnormalities of hormones levels such as melatonin, catecholamines, thyroid and parathyroid hormones are connected to occurrence of non-dipping hypertension. Other widely discussed problem is obstructive sleep apnoea and its influence on circadian rhythm changes. Also dysfunction in activity of renin-angiotensin-aldosterone axis is thought to cause non-dipping pattern. There are some studies that indicate on role of inappropriate sodium intake in mentioned pathology. The chronic kidney disease and relationship with non-dipping hypertension will be also described. The last considered factor is influence of age on the development of non-dipping hypertension.

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Keywords

circadian blood pressure profile, blood pressure regulation, chronobiology, nocturnal hypertension, non-dipping pathomechanism

About this article
Title

The current state of knowledge about the dipping and non-dipping hypertension

Journal

Arterial Hypertension

Issue

Vol 20, No 2 (2016)

Pages

33-43

Published online

2016-06-30

DOI

10.5603/AH.2016.0007

Bibliographic record

Arterial Hypertension 2016;20(2):33-43.

Keywords

circadian blood pressure profile
blood pressure regulation
chronobiology
nocturnal hypertension
non-dipping pathomechanism

Authors

Zbigniew Dubielski
Michał Zamojski
Bartosz Wiechecki
Olga Możeńska
Monika Petelczyc
Dariusz Artur Kosior

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