The dilemma of nocturnal blood pressure

Abstract

During the past decades, blood pressure (BP) measurement technique has evolved rapidly from the traditionally manual measuring to fully automatic monitoring. In terms of management of BP, there have been tremendous changes from the controlling of daytime BP, nondipping pattern to nocturnal BP (NBP). Since the focus has turned to NBP, a number of dilemmas of NBP measurement have gradually emerged in clinical practice and research settings, including methods for monitoring NBP, different period definition of nocturnal time, different diagnostic thresholds of abnormal NBP, whether to control abnormal NBP, and how to manage abnormal NBP. Currently, these issues have hindered progress in the appropriate management of hypertensive patients. Therefore, the purpose of this review is to concisely discuss the dilemmas of NBP.

Figure FIGURE

Interpretation of the relationship between nocturnal blood pressure (NBP) and morning blood pressure surge. Dawn phenomenon indicates normal NBP but high morning blood pressure surge; Somogyi effect, NBP lower than normal and the morning blood pressure surge excessively higher than normal in the early morning; poor BP control, abnormal BP not under appropriate control.