In young individuals aged 6-25 years, asymptomatic hypertension-mediated organ damage is associated with both nocturnal hypertension and non-dipping, but nighttime blood pressure levels appear to have the primary contributing role.
Non-dippers had significantly higher left ventricular mass index and carotid intima-media thickness compared to dippers after adjustment for covariates.
Individuals with nighttime hypertension had significantly higher LVMI than those with nighttime normotension.
In multivariable models, non-dipping independently associated with LVMI and IMT when adjusted for 24-h systolic BP, but this association was lost when adjusted for nighttime systolic BP.
Both dippers and non-dippers with nighttime hypertension had higher LVMI than dippers with nighttime normotension.
The study population of young individuals aged 6-25 years showed substantial prevalence of ambulatory BP hypertension, nighttime hypertension, and non-dipping.
This research suggests that in children and young adults (ages 6-25), nighttime blood pressure plays a crucial role in causing early, silent damage to the heart and blood vessels. The study used 24-hour ambulatory blood pressure monitoring to measure blood pressure around the clock, and examined the hearts and arteries of 276 young people using ultrasound. They found that both having high blood pressure at night and having a 'non-dipping' pattern (where blood pressure does not fall sufficiently during sleep) were associated with larger heart muscle mass and thicker artery walls — both signs of early cardiovascular damage. The most important finding was that when statistical models accounted for the actual level of nighttime blood pressure, the non-dipping pattern alone no longer independently predicted organ damage. This suggests that it is primarily how high the blood pressure is at night — not simply whether it fails to drop — that matters for organ health in young people. About one-quarter of participants had nighttime high blood pressure and nearly one-third were non-dippers, suggesting these are common findings in youth referred for blood pressure evaluation. This research suggests that clinicians evaluating young patients for blood pressure problems should pay particular attention to nighttime blood pressure levels when assessing cardiovascular risk and early organ damage, even in this age group where the absolute risk of heart disease is considered low. The findings support the value of 24-hour ambulatory monitoring, which captures nighttime readings that a standard office blood pressure measurement would miss.
Theodosiadi A, Kollias A, Stambolliu E, Ntineri A, Destounis A, Menti A, et al.. (2026). Nighttime blood pressure versus non-dipping for predicting asymptomatic organ damage in young individuals.. Journal of hypertension. https://doi.org/10.1097/HJH.0000000000004392