14. ABPM findings in a community Journal of Hypertension 2007, 25:977β984
15. Nocturnal BP Changes and CV Mortality: Ohasama study Extreme dippers Dippers Non-dippers Risers Risk of CV Mortality Ohkubo et al; AJH 1997; 10: 1201
16. Analysis of The Influence of the Morning Surge of BP on Stroke Incidence Cox regression analysis for clinical stroke events Covariates RR P value Age (10 yrs) 1.80 (1.21-2.69) 0.004 Male gender 1.42 (0.76-2.67) 0.266 BMI 0.98 (0.90-1.07) 0.663 24 hr SBP 1.37 (1.16-1.63) 0.003 Morning BP surge* 1.29 (1.10-1.51) 0.001 Nocturnal BP fall* 0.88 (0.73-1.06) 0.167 Lowest sleep BP 1.05 (0.65-1.71) 0.837 * per 10 mmHg Kario, Pickering et al, Circ 2003; 107:1401
21. Diuretics Convert Non-Dippers to Dippers Systolic pressure mmHg Day Night No Rx HCTZ No Rx HCTZ Dippers Non-Dippers Uzu & Kimura Circ 1999; 100:1635
22. Diuretics Convert Non-Dippers to Dippers Systolic pressure mmHg Day Night No Rx HCTZ No Rx HCTZ Dippers Non-Dippers Uzu & Kimura Circ 1999; 100:1635
23. Effects of Alpha-Blockade on the Morning Surge of Blood Pressure Kario, Pickering, et al Am J Hypertens 2004;17; 668 Doxazosin No Rx
24.
25. Pre Tx(n = 30) β CCB/DU + ARB Tx (n = 27) β Pre Tx + AB at bedtime
26.
27.
28. Question: If you were allowed just one reading over 24 hours to predict morbidity, which would you choose? Gosse et al, J Hum Hypertens 2001; 15: 413 Awake Awake Sleep Going to bed Arising Evening BP Lowest BP Preawake BP Morning BP
![Hypertension and Chronic Renal Disease: Hemodynamic Abnormalities Mean BP Total Systemic Vascular Resistance = X ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Increased Vasoconstriction ο Adrenergic Stimuli ο Angiotensin II ο Endothelin ο Endothelium-derived Contracting Factors ο Thromboxane Cardiac Output Decreased Vasodilation ο― Prostacyclin ο― Nitric oxide ο― EDHF* Textor SC. Atlas of Diseases of the Kidney, 2001. *Endothelium-derived Hyperpolarizing Factors www.hypertensiononline.org](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)