Korean J Intern Med.  2021 Sep;36(5):1126-1133. 10.3904/kjim.2021.022.

Prevalence and characteristics of isolated nocturnal hypertension in the general population

Affiliations
  • 1Cardiovascular Center, Dongguk University Ilsan Hospital, Goyang, Korea
  • 2Department of Statistics, Dongguk University, Seoul, Korea
  • 3Cardiovascular Center, Dongguk University Gyeongju Hospital, Gyeongju, Korea
  • 4Department of Clinical Pharmacology and Therapeutics, Dongguk University Ilsan Hospital, Goyang, Korea
  • 5Department of Cardiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
  • 6Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
  • 7Division of Cardiology, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea

Abstract

Background/Aims
Ascertaining the prevalence of isolated nocturnal hypertension (INHT) in the general population and identifying the characteristics of patients with INHT may be important to determine patients who should receive 24- hour ambulatory blood pressure (BP) measurements. This study aimed to evaluate the prevalence and characteristics of INHT in the general population.
Methods
Of 1,128 participants (aged 20 to 70 years), we analyzed 823 who had valid 24-hour ambulatory BP measurements and were not on antihypertensive drug treatment.
Results
The prevalence of INHT in the study was 22.8%. Individuals with INHT had a higher office, 24-hour, and daytime and nighttime ambulatory systolic and diastolic BPs compared to individuals with sustained day-night normotension. INHT was more prevalent in individuals with masked hypertension (MH) than in those with sustained hypertension (59.8% vs. 15.6%, p < 0.001). Among individuals with INHT, 92.6% had MH. Among individuals with office BP-based prehypertension, 34.5% had both INHT and MH. The prevalence of INHT was highest in individuals with office BP-based prehypertension. INHT was an independent determinant of MH after adjustment for age, sex, body mass index, diabetes, low-density-lipoprotein cholesterol, 24-hour systolic and diastolic BP, systolic and diastolic BP dipping, and systolic and diastolic BP non-dipping.
Conclusions
The present study showed that INHT is not uncommon and is a major determinant of MH. Our findings strongly suggest the use of 24-hour ambulatory BP measurement for individuals within the prehypertension range of office BP owing to the high prevalence of INHT and MH in this population.

Keyword

Nocturnal; Ambulatory blood pressure monitoring; Masked hypertension; Prehypertension
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