Clinical and prognostic significance of a reverse dipping pattern on ambulatory monitoring: An updated review
Open accessAbstract
Reverse or inverted dipping (ie, the phenomenon characterized by higher nighttime compared with daytime blood pressure values) is an alteration of circadian blood pressure rhythm frequently documented in hypertension, type 2 diabetes mellitus, chronic kidney disease, and sleep apnea syndrome, and generally regarded as a harmful condition. Available literature on the clinical and prognostic implications of reverse dipping is scanty. The present article will review a number of relevant issues concerning reverse dipping, in particular: (1) its possible mechanisms; (2) prevalence and clinical correlates, (3) concomitant cardiac and extracardiac subclinical organ damage; (4) association with acute and chronic cardiovascular diseases; (5) prognostic value in predicting cardiovascular events and mortality; and (6) therapeutic interventions aimed at reverting this abnormal circadian blood pressure rhythm.
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Reverse dipping is associated with increased sympathetic nervous system activity at night.
“Reverse dipping is also associated with increased sympathetic nervous system activity at night.55”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [55]
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Une n-acp d'un hypercube de donnees
de, E. P. M. (1986)
To assess the variation in nocturnal blood pressure among diabetic hypertensives
Manyam, A., Gattu, N., Basutkar, S. R., Yashilha, D., Kumar, J. S., & Padmanabhan, R. (2022) · International Journal of Health Sciences · doi:10.53730/ijhs.v6ns2.8533
- Authors
- Cuspidi, C., Sala, C., Tadic, M., Gherbesi, E., De Giorgi, A., Grassi, G., & Mancia, G.
- Affiliations
- IRCCS Istituto Auxologico Italiano (IT)
- University of Milan (IT)
- University Hospital Center Dr Dragiša Mišović (RS)
- Hypertension Centre Hospital V. Fazzi Lecce Italy
- MultiMedica (IT)
- University of Milano-Bicocca (IT)
- Corresponding author
- Cuspidi, Cesare
- Venue
- The Journal of Clinical Hypertension
- Publisher
- Wiley
- Published
- 2017-07
- Volume
- 19
- Issue
- 7
- Pages
- 713-721
- ISSN
- 1524-6175 (ISSN-L)
- 1751-7176
- PMC
- PMC8031119
- OpenAlex
- W2736301653
- Cited by
- 127
- References
- 62
- Citations by year
- 2026: 8 · 2025: 11 · 2024: 16 · 2023: 16 · 2022: 19 · 2021: 20 · 2020: 15 · 2019: 14 · 2018: 6 · 2017: 1
- FWCI
- 1.39
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Clinical Hypertension (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- BOA (University of Milano-Bicocca) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Keywords
- reverse dipping, circadian blood pressure rhythm, ambulatory blood pressure monitoring, hypertension, type 2 diabetes, chronic kidney disease, sleep apnea, cardiovascular risk, cardiovascular mortality, subclinical organ damage
- MeSH terms
- Adolescent, Adult, Aged, Blood Pressure, Cardiovascular Diseases, Circadian Rhythm, Diabetes Mellitus, Type 2, Female, Humans, Hypertension, Male, Middle Aged, Prognosis, Sleep, Sleep Apnea Syndromes, Prevalence, Blood Pressure Monitoring, Ambulatory, Renal Insufficiency, Chronic, Young Adult
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