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. 2021 Sep;36(5):1126-1133.
doi: 10.3904/kjim.2021.022. Epub 2021 Apr 5.

Prevalence and characteristics of isolated nocturnal hypertension in the general population

Moo-Yong Rhee  1 , Je Sang Kim  1 , Chee Hae Kim  1 , Ji-Hyun Kim  1 , Jung-Ha Lee  1 , Sun-Woong Kim  2 , Deuk-Young Nah  3 , Namyi Gu  4 , Eun-Joo Cho  5 , Ki-Chul Sung  6 , Kyung-Soon Hong  7
Affiliations

Prevalence and characteristics of isolated nocturnal hypertension in the general population

Moo-Yong Rhee et al. Korean J Intern Med. 2021 Sep.

Abstract

Background/aims: Ascertaining the prevalence of isolated nocturnal hypertension (INHT) in the general population and identifying the characteristics of patients with INHT may be important to determine patients who should receive 24- hour ambulatory blood pressure (BP) measurements. This study aimed to evaluate the prevalence and characteristics of INHT in the general population.

Methods: Of 1,128 participants (aged 20 to 70 years), we analyzed 823 who had valid 24-hour ambulatory BP measurements and were not on antihypertensive drug treatment.

Results: The prevalence of INHT in the study was 22.8%. Individuals with INHT had a higher office, 24-hour, and daytime and nighttime ambulatory systolic and diastolic BPs compared to individuals with sustained day-night normotension. INHT was more prevalent in individuals with masked hypertension (MH) than in those with sustained hypertension (59.8% vs. 15.6%, p < 0.001). Among individuals with INHT, 92.6% had MH. Among individuals with office BP-based prehypertension, 34.5% had both INHT and MH. The prevalence of INHT was highest in individuals with office BP-based prehypertension. INHT was an independent determinant of MH after adjustment for age, sex, body mass index, diabetes, low-density-lipoprotein cholesterol, 24-hour systolic and diastolic BP, systolic and diastolic BP dipping, and systolic and diastolic BP non-dipping.

Conclusion: The present study showed that INHT is not uncommon and is a major determinant of MH. Our findings strongly suggest the use of 24-hour ambulatory BP measurement for individuals within the prehypertension range of office BP owing to the high prevalence of INHT and MH in this population.

Keywords: Ambulatory blood pressure monitoring; Masked hypertension; Nocturnal; Prehypertension.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1.
Figure 1.
Prevalence of isolated nocturnal hypertension, isolated daytime hypertension, and day-night hypertension in individuals with masked and sustained hypertension. The prevalence of isolated nocturnal hypertension is higher in masked hypertension than in sustained hypertension. The prevalence of daytime-nighttime hypertension is higher in sustained hypertension than in masked hypertension.
Figure 2.
Figure 2.
The overlap between subjects with prehypertension, masked hypertension, and isolated nocturnal hypertension. Among those with isolated nocturnal hypertension, 174 (92.6%) have masked hypertension. Among individuals within the prehypertension range of office blood pressure, 99 (34.5%) have both isolated nocturnal hypertension and masked hypertension, and 190 (66.2%) have masked hypertension. The numbers indicate the number of cases in each group.
Figure 3.
Figure 3.
Prevalence of isolated nocturnal hypertension, isolated daytime hypertension, and day-night hypertension according to office blood pressure levels. The prevalence of isolated nocturnal hypertension is highest in individuals within the prehypertension range of office blood pressure (34.5%). The prevalence of isolated nocturnal hypertension is 17.0% in those with optimal office blood pressure levels.
See this image and copyright information in PMC

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