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(Hypertension. 2007;49:1213.)
© 2007 American Heart Association, Inc.

Editorial Commentaries

Night and Day

What Blood Pressure Matters?

Denis L. Clement

From the University of Ghent, University Hospital, Ghent, Belgium.

Correspondence to Denis L. Clement, University of Ghent, University Hospital, Building 3K3, 185 De Pintelaan, B-9000 Ghent, Belgium. E-mail denis.clement@UGent.be

An extract of the first 250 words of the full text is provided, because this article has no abstract.

There is ample evidence that ambulatory blood pressure is significantly correlated with long-term prognosis. Such prognostic value holds true even after adjustment for the traditional risk factors and, more importantly, for office blood pressure.¹ Therefore, ambulatory blood pressure monitoring is very useful when facing the decision to start treatment in hypertensive patients and to perform adequate follow-up. However, even with all of the technical improvements, 24-hour recordings are not always accepted well by the patients, because it may disturb both their daytime activities and sleep quality.

A logical question arising in this respect is to what extent we need the full 24-hour recordings to assess such prognostic information. Are there periods in the 24 hours that carry a heavier weight in prognosis? In particular, do we need nighttime recordings? These are considered by many patients as the most unpleasant part of the monitoring.

This has opened a controversy in the literature about the value of nighttime blood pressure, including the discussion around the significance of dipping versus nondipping patterns. One can find as many advocates in favor of the value of nighttime blood pressure and dipping^2,3 as opponents.⁴ In the Office Versus Ambulatory Pressure Study,¹ systolic blood pressure at night significantly correlated with long-term prognosis, but the correlation was not stronger, even weaker, than that of daytime blood pressure. Reasons for such controversy may come from technical aspects but also largely from the definition of night blood pressure (preset clock time versus information coming from log books) and obviously also . . . [Full Text of this Article]

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Predictors of All-Cause Mortality in Clinical Ambulatory Monitoring: Unique Aspects of Blood Pressure During Sleep

Iddo Z. Ben-Dov, Jeremy D. Kark, Drori Ben-Ishay, Judith Mekler, Liora Ben-Arie, and Michael Bursztyn
Hypertension 2007 49: 1235-1241. [Abstract] [Full Text] [PDF]