Summary
Non invasive 24 hours ambulatory blood pressure monitoring was performed in 81 patients with secondary hypertension (renoparenchymatous nephropathyn=15, diabetic nephropathyn=10, Conn's diseasen=4, renal artery stenosisn=15, pheochromocytoman=2, hemodialysis patientsn=15 and patients after kidney transplantationn=20). The results were compared to 201 patients with essential hypertension.
The results showed that 98.5% of patients with essential hypertension have a nightly decline in blood pressure of at least 15 mmHg (systolic+diastolic), whereas 69% of patients with secondary hypertension showed either an attenuated circadian rhythm or no circadian rhythm. Patients with pheochromocytoma who had a night time increase in blood pressure demonstrated the greatest difference to the essential hypertension collective followed by patients with diabetic nephropathy, Conn's disease and the group of patients after kidney transplantation. After successful treatment of the condition leading to hypertension circadian periodicity returned in some patients.
In summary these results suggest that the absence of a night time decline in blood pressure during 24-hour-ambulatory monitoring is an indication of secondary hypertension.
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Schrader, J., Person, C., Pfertner, U. et al. Fehlender nächtlicher Blutdruckabfall in der 24-Stunden Blutdruckmessung: Hinweis auf eine sekundäre Hypertonie. Klin Wochenschr 67, 659–665 (1989). https://doi.org/10.1007/BF01718026
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DOI: https://doi.org/10.1007/BF01718026