How to deal with non-dipper hypertension

In a patient with arterial hypertension without disturbing the structure of the circadian rhythm of regulatory systems, as in a healthy person, the blood pressure is lower at the night time than at the daytime. Arterial hypertension with a preserved daily cycle of blood pressure is called a dipper.

Non-dipper pattern in the ABPM registry in a renal transplant patient.  

Non-dipper hypertension, by contrast, does not have an overnight drop in blood pressure. It is the most dangerous because it leads to the development of various cardiovascular complications, the most formidable of which is a stroke.

Clinical studies show that in the general population of patients with arterial hypertension and normal renal function, calcium antagonists, angiotensin-converting enzyme and angiotensin receptor II inhibitors when given before bedtime can restore the dipper status in night blood pressure.

The situation is different in patients with kidney disease, as these medications fail to lower the nocturnal blood pressure and the question arises, what to do? It turns out that to a large extent the problem can be solved with the intervention into sleep with the elimination of the so-called sleep apnea.

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