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Review
. 2007 Feb;23(2):132-8.
doi: 10.1016/s0828-282x(07)70733-x.

Night-time blood pressure patterns and target organ damage: a review

Faye S Routledge  1 , Judith A McFetridge-Durdle, C R Dean; Canadian Hypertension Society
Affiliations
Review

Night-time blood pressure patterns and target organ damage: a review

Faye S Routledge et al. Can J Cardiol. 2007 Feb.

Abstract
in English, French

Background: Individuals who do not have a 10% to 20% reduction in blood pressure (BP) during the night are known as 'nondippers'. The cause of this nondipping phenomenon is not fully understood; however, there is a growing body of evidence linking a nondipping BP pattern with target organ damage.

Objective: To review the literature and present an overview of the target organ damage found to be associated with a nondipping BP pattern.

Methods: PubMed, CINAHL and Medscape searches of all available English language articles from 1986 to 2005 were performed. Search terms included 'BP nondipping', 'BP dipping' and 'target organ damage'.

Results: There is evidence to suggest that individuals with hypertension who exhibit a nondipping BP profile are at higher risk of cardiac and extracardiac morbidity and mortality. In particular, nondippers with essential hypertension have been found to have more advanced left ventricular hypertrophy, left ventricular mass and left ventricular mass index, carotid artery wall thickness, carotid artery atherosclerotic plaques, silent cerebral infarct, stroke, cognitive impairment and microalbuminuria.

Conclusion: A better understanding of the importance of the circadian variations of BP may help to identify those at higher risk of cardiovascular morbidity and mortality, as well as lay the foundation for interventions to prevent/treat alterations in night-time BP patterns.

HISTORIQUE :: Les personnes qui ne présentent pas une baisse de 10 % à 20 % de leur tension artérielle (TA) la nuit sont appelées nondippers. La cause de ce phénomène n’est pas entièrement élucidée. Par contre, les preuves s’accumulent quant à l’existence d’un lien possible entre l’absence de fluctuation à la baisse de la TA (ou nondipping) et l’atteinte des organes cibles.

OBJECTIF :: Passer en revue la littérature et présenter une vue d’ensemble de l’atteinte des organes cibles observée en lien avec l’absence de fluctuation à la baisse de la TA nocturne.

MÉTHODES :: Les auteurs ont interrogé les réseaux PubMed, CINAHL et Medscape pour recenser tous les articles de langue anglaise accessibles publiés entre 1986 et 2005. Les motsclés de l’interrogation étaient « BP nondipping », « BP dipping » et « target organ damage ».

RÉSULTATS :: Selon les preuves recueillies, les hypertendus dont la TA ne diminue pas la nuit sont exposés à un risque plus élevé de morbidité et de mortalité cardiaques et extracardiaques. Parmi les nondippers atteints d’hypertension essentielle, on a particulièrement noté la présence plus marquée des manifestations suivantes : hypertrophie ventriculaire gauche, augmentation de la masse ventriculaire gauche ou de l’indice de masse ventriculaire gauche et de l’épaisseur de la paroi artérielle carotidienne, plaques athéroscléreuses carotidiennes, infarctus cérébraux silencieux, AVC, atteinte cognitive et microalbuminurie.

CONCLUSION :: Une meilleure compréhension de l’importance des variations nycthémérales de la TA pourrait contribuer à l’identification des sujets exposés à un risque plus élevé de morbidité et de mortalité cardiovasculaires et constituer la base de nouvelles interventions axées sur la prévention et le traitement du phénomène de nondipping.

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