de la Sierra, AlejandroRedon, JosepBanegas, José RSegura, JuliánParati, GianfrancoGorostidi, Manuelde la Cruz, Juan JSobrino, JavierLlisterri, José LAlonso, JavierVinyoles, ErnestPallarés, VicenteSarría, AntonioAranda, PedroRuilope, Luis M2012-09-252012-09-252009-03de la Sierra A, Redon J, Banegas JR, Segura J, Parati G, Gorostidi M, et al. Prevalence and factors associated with circadian blood pressure patterns in hypertensive patients. Hypertension. 2009 Mar; 53(3):466-720194-911Xhttp://hdl.handle.net/10668/485Comment in Timing of antihypertensive therapy and circadian blood pressure pattern. [Hypertension. 2009] Timing of antihypertensive therapy and circadian blood pressure pattern. Almirall J, Martínez-Ocaña JC, Comas L. Hypertension. 2009 Jun; 53(6):e41; author reply e42. Epub 2009 May 4. Dipping comes of age: the importance of nocturnal blood pressure. [Hypertension. 2009]. Dipping comes of age: the importance of nocturnal blood pressure. O'Brien E. Hypertension. 2009 Mar; 53(3):446-7. Epub 2009 Jan 26.Nondipping in patients with hypertension. [Hypertension. 2009]Ambulatory blood pressure (BP) monitoring has become useful in the diagnosis and management of hypertensive individuals. In addition to 24-hour values, the circadian variation of BP adds prognostic significance in predicting cardiovascular outcome. However, the magnitude of circadian BP patterns in large studies has hardly been noticed. Our aims were to determine the prevalence of circadian BP patterns and to assess clinical conditions associated with the nondipping status in groups of both treated and untreated hypertensive subjects, studied separately. Clinical data and 24-hour ambulatory BP monitoring were obtained from 42,947 hypertensive patients included in the Spanish Society of Hypertension Ambulatory Blood Pressure Monitoring Registry. They were 8384 previously untreated and 34,563 treated hypertensives. Twenty-four-hour ambulatory BP monitoring was performed with an oscillometric device (SpaceLabs 90207). A nondipping pattern was defined when nocturnal systolic BP dip was <10% of daytime systolic BP. The prevalence of nondipping was 41% in the untreated group and 53% in treated patients. In both groups, advanced age, obesity, diabetes mellitus, and overt cardiovascular or renal disease were associated with a blunted nocturnal BP decline (P<0.001). In treated patients, nondipping was associated with the use of a higher number of antihypertensive drugs but not with the time of the day at which antihypertensive drugs were administered. In conclusion, a blunted nocturnal BP dip (the nondipping pattern) is common in hypertensive patients. A clinical pattern of high cardiovascular risk is associated with nondipping, suggesting that the blunted nocturnal BP dip may be merely a marker of high cardiovascular risk.encircadian blood pressure patternnocturnal blood pressure dipcardiovascular risk factorsFactores de riesgo cardiovascularMedical Subject Headings::Named Groups::Persons::Age Groups::Adult::AgedMedical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Cardiovascular Agents::Antihypertensive AgentsMedical Subject Headings::Phenomena and Processes::Circulatory and Respiratory Physiological Phenomena::Cardiovascular Physiological Phenomena::Hemodynamics::Blood PressureMedical Subject Headings::Phenomena and Processes::Physiological Phenomena::Chronobiology Phenomena::Periodicity::Circadian RhythmMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort StudiesMedical Subject Headings::Check Tags::FemaleMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::HumansMedical Subject Headings::Diseases::Cardiovascular Diseases::Vascular Diseases::HypertensionMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Models, Statistical::Linear ModelsMedical Subject Headings::Check Tags::MaleMedical Subject Headings::Named Groups::Persons::Age Groups::Adult::Middle AgedMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Morbidity::PrevalenceMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::RegistriesMedical Subject Headings::Geographicals::Geographic Locations::Europe::SpainMedical Subject Headings::Named Groups::Persons::Age Groups::AdultMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Monitoring, Physiologic::Monitoring, Ambulatory::Blood Pressure Monitoring, Ambulatoryresearch article19171788open access10.1161/HYPERTENSIONAHA.108.1240081524-4563