Cited by 379Blood Pressure and Hypertension StudiesCardiovascular Health and Disease PreventionSodium Intake and Health

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Prevalence and Factors Associated With Circadian Blood Pressure Patterns in Hypertensive Patients

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de la Sierra, Alejandro, Redon, Josep, Banegas, José R., Segura, Julián, Parati, Gianfranco, Gorostidi, Manuel, de la Cruz, Juan J., Sobrino, Javier, Llisterri, José L., Alonso, Javier, Vinyoles, Ernest, Pallarés, Vicente, Sarría, Antonio, Aranda, Pedro, Ruilope, Luis M.·2009·Hypertension

DOI 10.1161/hypertensionaha.108.124008

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Abstract

Ambulatory blood pressure (BP) monitoring has become useful in the diagnosis and management of hypertensive individuals. In addition to 24-hour values, the circadian variation of BP adds prognostic significance in predicting cardiovascular outcome. However, the magnitude of circadian BP patterns in large studies has hardly been noticed. Our aims were to determine the prevalence of circadian BP patterns and to assess clinical conditions associated with the nondipping status in groups of both treated and untreated hypertensive subjects, studied separately. Clinical data and 24-hour ambulatory BP monitoring were obtained from 42 947 hypertensive patients included in the Spanish Society of Hypertension Ambulatory Blood Pressure Monitoring Registry. They were 8384 previously untreated and 34 563 treated hypertensives. Twenty-four-hour ambulatory BP monitoring was performed with an oscillometric device (SpaceLabs 90207). A nondipping pattern was defined when nocturnal systolic BP dip was <10% of daytime systolic BP. The prevalence of nondipping was 41% in the untreated group and 53% in treated patients. In both groups, advanced age, obesity, diabetes mellitus, and overt cardiovascular or renal disease were associated with a blunted nocturnal BP decline ( P <0.001). In treated patients, nondipping was associated with the use of a higher number of antihypertensive drugs but not with the time of the day at which antihypertensive drugs were administered. In conclusion, a blunted nocturnal BP dip (the nondipping pattern) is common in hypertensive patients. A clinical pattern of high cardiovascular risk is associated with nondipping, suggesting that the blunted nocturnal BP dip may be merely a marker of high cardiovascular risk.

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10.1161/hyp.31.2.712 · DOI
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Authors: de la Sierra, A., Redon, J., Banegas, J. R., Segura, J., Parati, G., Gorostidi, M., de la Cruz, J. J., Sobrino, J., Llisterri, J. L., Alonso, J., Vinyoles, E., Pallarés, V., Sarría, A., Aranda, P., & Ruilope, L. M.
Affiliations: From the Hypertension Unit (A.d.l.S.), Hospital Clínic, University of Barcelona, Barcelona, Spain; Hypertension Unit, Hospital Clínico (J.R.), University of Valencia and Centro de Investigación Biomédica au Red (CIBER) of Obesity and Nutritional Disorders, Valencia, Spain; Department of Preventive Medicine and Public Health (J.R.B., J.J.d.l.C.), Autonomous University and CIBER of Epidemiology and Public Health, Madrid, Spain; Hypertension Unit (J.Segura, L.M.R.), Hospital 12 de Octubre, Madrid,...
Universidad Complutense de Madrid (ES)
Universitat Autònoma de Barcelona (ES)
ORCID: Segura, Julián
Parati, Gianfranco
Gorostidi, Manuel
Sobrino, Javier
Vinyoles, Ernest
Ruilope, Luis M.
Venue: Hypertension
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2009-03
Volume: 53
Issue: 3
Pages: 466-472
ISSN: 0194-911X (ISSN-L)
1524-4563
DOI: 10.1161/hypertensionaha.108.124008
OpenAlex: W2137218363
Semantic Scholar: 1acddbb4ed2a4020230b89f1921ced018ea70f76
Cited by: 379
References: 34
Citations by year: 2026: 14 · 2025: 17 · 2024: 24 · 2023: 19 · 2022: 11 · 2021: 17 · 2020: 22 · 2019: 22 · 2018: 22 · 2017: 19 · 2016: 17 · 2015: 28 · 2014: 28 · 2013: 23 · 2012: 31
FWCI: 20.70
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Hypertension (publishedVersion)
PubMed (publishedVersion)
BOA (University of Milano-Bicocca) (submittedVersion)
RISalud Institutional Health Repository of Andalucía (submittedVersion, other-oa)
Zenodo (CERN European Organization for Nuclear Research) (submittedVersion, cc-by)
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
Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
Keywords: circadian blood pressure rhythm, non-dipping blood pressure, ambulatory blood pressure monitoring, nocturnal blood pressure dipping, cardiovascular risk, antihypertensive drugs, obesity, diabetes mellitus, kidney disease, untreated hypertension
MeSH terms: Adult, Aged, Antihypertensive Agents, Blood Pressure, Circadian Rhythm, Female, Humans, Hypertension, Male, Middle Aged, Registries, Spain, Cohort Studies, Prevalence, Linear Models, Blood Pressure Monitoring, Ambulatory

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Prevalence and Factors Associated With Circadian Blood Pressure Patterns in Hypertensive Patients

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