Open AccessClinical and prognostic significance of a reverse dipping pattern on ambulatory monitoring: An updated review
Author(s) -
Cuspidi Cesare,
Sala Carla,
Tadic Marijana,
Gherbesi Elisa,
De Giorgi Antonio,
Grassi Guido,
Mancia Giuseppe
Publication year - 2017
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.13023
Subject(s) - medicine , subclinical infection , circadian rhythm , ambulatory blood pressure , blood pressure , cardiology , diabetes mellitus , kidney disease , sleep apnea , intensive care medicine , clinical significance , disease , endocrinology
Reverse or inverted dipping (ie, the phenomenon characterized by higher nighttime compared with daytime blood pressure values) is an alteration of circadian blood pressure rhythm frequently documented in hypertension, type 2 diabetes mellitus, chronic kidney disease, and sleep apnea syndrome, and generally regarded as a harmful condition. Available literature on the clinical and prognostic implications of reverse dipping is scanty. The present article will review a number of relevant issues concerning reverse dipping, in particular: (1) its possible mechanisms; (2) prevalence and clinical correlates, (3) concomitant cardiac and extracardiac subclinical organ damage; (4) association with acute and chronic cardiovascular diseases; (5) prognostic value in predicting cardiovascular events and mortality; and (6) therapeutic interventions aimed at reverting this abnormal circadian blood pressure rhythm.