The Night Side of Blood Pressure: Nocturnal Blood Pressure Dipping and Emotional (dys)Regulation

Dipping comes of age: the importance of nocturnal blood pressure.

It is now just 21 years since the dipping phenomenon was described in a letter to The Lancet.1 In a cohort of 123 consecutive patients who had ambulatory blood pressure (BP) measurement (ABPM) performed, the majority (83%) were dippers on the basis of having a difference of 10/5 mm Hg between day and nighttime BPs, with 17% being nondippers. The nondippers had a significantly higher frequency o...

Nocturnal blood pressure dipping in the hypertension of autonomic failure.

Blood pressure (BP) normally decreases during the night. Absence of this phenomenon (nondipping) is associated with increased cardiovascular risk. Altered autonomic and endocrine circadian rhythms are suspected to play a role. Patients with peripheral autonomic failure offer a unique opportunity to study this phenomenon, because approximately 50% develop supine hypertension despite very low aut...

Nocturnal sodium excretion, blood pressure dipping, and sodium sensitivity.

More than 30 years ago, Guyton1 described pressurenatriuresis: increasing arterial blood pressure promotes sodium excretion, decreasing blood volume and lowering blood pressure, whereas when blood pressure falls, sodium excretion decreases, and blood volume and blood pressure increase.1,2 The linchpin of the model of Guyton et al3 is the concept of feedback gain. Gain is the degree to which a f...

Night-time blood pressure: dipping into the future?

In this issue of the journal, Ohkubo et al. [1] extend their previous preliminary findings [2] in 1542 inhabitants of Ohasama, Japan by increasing mean follow-up from 4.1 years to 9.2 years. The Japanese researchers [1] noticed a linear and inverse relationship between cardiovascular mortality and the nocturnal decline in blood pressure, which was independent of the overall blood pressure load ...

Health Psychology Neighborhood Problems and Nocturnal Blood Pressure Dipping