Differential Effects of an .ALPHA.1-Blocker(Doxazosin) on Diurnal Blood Pressure Variation in Dipper and Non-Dipper Type Hypertension.

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Abstract
A study was conducted to determine whether sympathetic nerve activity, one of the main regulators of blood pressure, is involved in high blood pressure in the night-time and morning. Twenty-seven untreated hypertensive subjects, in whom hypertension was diagnosed by ambulatory blood pressure (ABP) measurement, who showed a 24h systolic ABP value over 140mmHg and/or 24h diastolic ABP over 90 mmHg were recruited. They also showed a night-time systolic ABP value of over 130mmHg and/or a night-time diastolic ABP of over 80mmHg. They were divided into two groups: "dippers (D)" whose night-time ambulatory blood pressure fell by more than 10% of the day-time blood pressure, and "nondippers (ND)" in whom this phenomenon was absent. We examined the effect of a long-acting α1-blocker (doxazosin) on diurnal blood pressure variation in these subjects with essential hypertension. Baseline casual blood pressure and 24h systolic ABP were not significantly different between the two groups. However, both night-time and morning ABP in ND were higher than those in D. Administration of doxazosin (mean 73±13 (SE) d) significantly decreased casual blood pressure, and 24h, day-time, nighttime and morning systolic ABP in the whole cohort. When subjects were divided into D and ND, the day-time and morning systolic ABP decreased significantly after doxazosin treatment in both groups, whereas the night-time systolic ABP decreased significantly only in ND but not in D. These results suggest that sympathetic nerve activity involved in elevating blood pressure during the night may differ between D and ND. (Hypertens Res 1995; 18: 125-130)

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