Abstract
A 71-year-old, Caucasian female, diagnosed of hypertension at 52 years of age, was followed up in our centre from the age of 65 years. She was diagnosed as true resistant hypertensive and treated with four drugs, including spironolactone. 24-h ambulatory blood pressure monitoring (ABPM) was performed, and the final diagnosis was nocturnal hypertension.
Threshold for nocturnal hypertension diagnosis based on ABPM is an average night-time blood pressure (BP) ≥120/70 mmHg. Night-time BP is the most potent predictor of cardiovascular outcomes. Reduction of nocturnal hypertension should be a therapeutic objective, in order to achieve effective BP control over the entire 24-h period.
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References
O’Brien E, Parati G, Stergiou G Asmar R, Beilin L, Bilo G, et al., on behalf of the European Society of Hypertension Working Group on Blood Pressure Monitoring. European Society of Hypertension Position Paper on ambulatory blood pressure monitoring. J Hypertens. 2013;31:1731–68.
Dolan E, Stanton A, Thijs L, Hinedi K, Atkins N, McClory S, et al. Superiority of ambulatory over clinic blood pressure measurement in predicting mortality: the Dublin outcome study. Hypertension. 2005;46:156–61.
Kikuya M, Ohkubo T, Asayama K, Metoki H, Obara T, Saito S, et al. Ambulatory blood pressure and 10-year risk of cardiovascular and noncardiovascular mortality: the Ohasama study. Hypertension. 2005;45:240–5.
de la Sierra A, Banegas JR, Segura J, Gorostidi M, Ruilope LM, on behalf of the Cardiorisc Event Investigators. Ambulatory blood pressure monitoring and development of cardiovascular events in high-risk patients included in the Spanish ABPM registry: the cardiorisc event study. J Hypertens. 2012;30:713–9.
Banegas JR, Ruilope LM, de la Sierra A, Vinyoles E, Gorostidi M, de la Cruz JJ, et al. Relationship between clinic and ambulatory blood-pressure measurements and mortality. N Engl J Med. 2018;378:1509–20.
Fagard RH, Celis H, Thijs L, Staessen JA, Clement DL, De Buyzere ML, et al. Daytime and nighttime blood pressure as predictors of death and cause-specific cardiovascular events in hypertension. Hypertension. 2008;51:55–61.
Ohkubo T, Hozawa A, Yamaguchi J, Kikuya M, Ohmori K, Michimata M, et al. Prognostic significance of the nocturnal decline in blood pressure in individuals with and without high 24-h blood pressure: the Ohasama study. J Hypertens. 2002;20:2183–9.
Fan HQ, Li Y, Thijs L, Hansen TW, Boggia J, Kikuya M, on behalf of the International Database on Ambulatory blood pressure monitoring in relation to Cardiovascular Outcomes (IDACO) Investigators. Prognostic value of isolated nocturnal hypertension on ambulatory measurement in 8711 individuals from 10 populations. J Hypertens. 2010;28:2036–5.
de la Sierra A, Gorostidi M, Banegas JR, Segura J, de la Cruz JJ, Ruilope LM. Nocturnal hypertension or nondipping: which is better associated with the cardiovascular risk profile? Am J Hypertens. 2014;27:680–7.
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Segura, J. (2019). Patient with Isolated Nocturnal Hypertension. In: Hypertension and 24-hour Ambulatory Blood Pressure Monitoring. Practical Case Studies in Hypertension Management. Springer, Cham. https://doi.org/10.1007/978-3-030-02741-4_4
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DOI: https://doi.org/10.1007/978-3-030-02741-4_4
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