Should we measure blood pressure at night to diagnose hypertension?

<p>In this episode, we talk to Dr Laura Armitage, a GP and Doctoral Research Fellow at the Nuffield Department of Primary Health Care Sciences at the University of Oxford.&nbsp;Laura and her team conducted a study looking at a common issue in primary care: hypertension, and how to measure it in practice.</p><p><em>Title of paper: Diagnosing hypertension in primary care: the importance of night-time blood pressure assessment.&nbsp;</em></p><p><strong>Available at: </strong><a href="https://doi.org/10.3399/BJGP.2022.0160" rel="noopener noreferrer" target="_blank"><strong>https://doi.org/10.3399/BJGP.2022.0160</strong></a></p><p>Since the 1990s, the phenotypic classification of 24-hour blood pressure has divided the population into ‘dippers’, ‘non-dippers’ (minimal night-time BP decrease compared to daytime BP) and ‘reverse dippers’ (night-time BP increases compared to day-time BP).&nbsp;There is an established body of research demonstrating that reverse dippers are at higher risk of death and that the night-day systolic blood pressure ratio is an independent predictor of all cause mortality and cardiovascular events.&nbsp;Presently, UK guidelines suggest clinicians should diagnose hypertension based solely on daytime BP measurements.&nbsp;This study reveals a marked proportion of our population are reverse dippers; together with the established clinical research that has demonstrated worse cardiovascular outcomes for such patients, this highlights the need for 24-hour ambulatory blood pressure assessments to detect and diagnose those with nocturnal hypertension, non-dipping or reverse-dipping blood pressure phenotypes.</p><p>&nbsp;</p>