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To the Editor:I have read the article by Viera et al1 demonstrating that disrupted circadian rhythm of blood pressure (BP) in youth was a predictor of coronary calcium levels in younger adults. The study is of great interest because, although an association between normotensive nondippers and advanced target organ damage is expected,2 the risk of extreme dipping was unexpected in younger subjects.In 1999, we first demonstrated a U curve-shaped association between nocturnal BP …

Is the Atherosclerotic Risk of Extreme Dipping in Youth Partly Explained by Exaggerated Morning Surge?