What is the Origin of Non-Dipping Hypertension?

The term is derived from the observation, made possible by 24-hour ambulatory blood pressure monitoring, that blood pressure naturally "dips" during sleep. The classification of non-dipping emerged in the context of cardiovascular risk stratification to identify patients with a particularly unfavorable prognosis.

What is the Mechanism of Non-Dipping Hypertension?

The normal nocturnal BP dip is regulated by the autonomic nervous system and the renin-angiotensin-aldosterone system (RAAS), which typically decrease activity during sleep. Non-dipping often results from an inappropriate activation of the sympathetic nervous system or RAAS during the night, leading to sustained vascular tone. Hormonal factors, such as high nocturnal cortisol levels or aldosterone dysregulation, are frequently implicated in this pathological loss of the normal circadian rhythm of blood pressure.

Non-Dipping Hypertension ∞ Area

Non-Dipping Hypertension

Meaning

A clinically significant pattern of hypertension characterized by the absence of the normal physiological drop in blood pressure (BP) during nighttime sleep, defined as a nocturnal BP reduction of less than 10-20% compared to daytime values. This altered circadian rhythm of blood pressure is associated with a significantly increased risk of cardiovascular events and end-organ damage, including stroke and kidney disease. Ambulatory blood pressure monitoring is the gold standard for its diagnosis.