Non-dipper hypertension: its pathophysiology, etiology and association with cardiovascular outcomes

Abstract

Circadian blood pressure variations are classified into different phenotypes that provide additional knowledge about patients' morbidity and prognosis. Ambulatory blood pressure monitoring (ABPM) is the ideal tool for obtaining a record of these variations. The etiology of non-dipper hypertension is multifactorial, including dysregulations in the autonomic nervous system, neuroendocrine axes, and mineral turnover system, with complex pathophysiological behavior. There are many associations between altered circadian phenotypes (such as the non-dipper phenotype) and adverse cardiovascular outcomes such as cardiovascular mortality, coronary and cerebrovascular disease, chronic kidney disease, and hospitalization for heart failure. Knowledge of these aspects is essential in determining special risk groups in patients with hypertension.