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.........., Rensa/Yudis2
1. Faculty of Medicine, Atmajaya Catholic University of Indonesia, Jakarta, Indonesia.
2. Department of Internal Medicine, Faculty of Medicine, Atmajaya Catholic University of
Indonesia, Jakarta, Indonesia.
Correspondence author:
Faculty of Medicine, Atmajaya Catholic University of Indonesia, Jakarta, Indonesia.
Email:
Introduction
Hypertension had been long time well studied as one of main cardiovascular disease (CVD)
risk factor, that made every physicians routinely prescribed anti hypertensive drug to
maintain normal blood pressure.1 However, the diagnosis of nocturnal hypertension tend to be
missed although it was important predictor of all cause mortality and/or cardiovascular
mortality.2 Lack of awareness with hypertension made the patients measure their blood
pressure only in hospital visit. This factor contributed to the limited use of ambulatory blood
pressure measurement, and the possibility of nocturnal hypertension became overlooked.3 In
this review, we described the definition, epidemiology, pathophysiology, clinical significance,
diagnosis, and anti hypertension management of isolated hypertension.
glomerular filtration rate (GFR).g Farmar et al, found there was direct correlation between
plasma creatinine level and percent of blood pressure declining at night. From their 380
patients retrospective data, non-dipping phenomenon were more prevalent in CKD patients
(53%) than in patients with essential hypertension (30%).h Wang et al reported among 540
Chinese CKD patients, total of 21,9% patients had nighttime blood pressure increased
(reversed dipper), 36,1 % patients were dipper, and 42% of patients were non-dipper.i
However, increased daily salt intake also found to be related with nocturnal hypertension
Kidneys will compensate high sodium intake by enhancing natriuresis during the night,
resulting in elevated nighttime blood pressure. Blood pressure will remain elevated until
kidneys succeed in reducing excess sodium.k
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2. Friedman O, Logan AG. Can nocturnal hypertension predict cardiovascular risk? Integr
Blood Press Control. 2009 Sep 4;2:2537.
3. Li Y, Wang J-G. Isolated Nocturnal Hypertension A Disease Masked in the Dark.
Hypertension. 2013 Feb 1;61(2):27883.
4. Kanbay M, Turgut F, Uyar ME, Akcay A, Covic A. Causes and mechanisms of nondipping
hypertension. Clin Exp Hypertens. 2008 Oct;30(7):58597.