ArticlePhysiological reports2020
Nocturnal blood pressure is associated with sympathetic nerve activity in patients with chronic kidney disease.
Article in Physiological reports, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers.
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Who cites it
31 citing papers in PubMed, 38 citations in OpenAlex.
- Pathophysiology, diagnosis and intervention strategies of nocturnal hypertension.Journal of human hypertension · 2026Review
- Circadian regulation of cardiovascular function: from physiology to clinical implications.Genome medicine · 2026Review
- EASIX and Arterial stiffness in relation to nocturnal blood pressure patterns in newly diagnosed hypertension.Journal of human hypertension · 2026Article
- Renal denervation triage tool: a practical approach to the management of resistant hypertension.AsiaIntervention · 2026Review
- Circadian Influences on Chronic Kidney Disease Progression: Molecular Signaling Pathways of Melatonin and Their Therapeutic Potential.Pharmaceuticals (Basel, Switzerland) · 2026Review
- Association between postoperative nocturnal blood pressure rising and mortality in patients receiving cardiac surgery: a retrospective cohort study.BMC cardiovascular disorders · 2026Article
- 24-hour diastolic blood pressure average real variability predicts renal progression in diabetic kidney disease: a comprehensive cohort study.Frontiers in endocrinology · 2026Article
- Association between sleep duration and estimated glomerular filtration rate in Chinese patients with diabetes: evidence from a cross-sectional study.European journal of medical research · 2025Observational
- Hypertension burden in CKD: is nocturnal hypertension the primary culprit?Clinical kidney journal · 2025Review
- Effects of reduced blood pressure dipping on the progression of chronic kidney disease in children.BMC pediatrics · 2025Article
- Social Determinants of Health and Nocturnal Hypertension in the Chronic Renal Insufficiency Cohort.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2025Article
- Blood pressure variability in CKD patients with and without nocturnal hypertension.Journal of human hypertension · 2025Article
- Sympathetic transduction to blood pressure in patients with chronic kidney disease.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2025Article
- Cardiovascular autonomic neuropathy in chronic kidney disease: a study of kidney biopsy cases.BMC nephrology · 2024Article
- Predictors of daytime blood pressure, nighttime blood pressure, and nocturnal dipping in patients with chronic kidney disease.Hypertension research : official journal of the Japanese Society of Hypertension · 2024Article
- Review
- Current perspective on circadian function of the kidney.American journal of physiology. Renal physiology · 2024Review
- Augmented resting beat-to-beat blood pressure variability in patients with chronic kidney disease.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2023Article
- Short-term blood pressure variability as a potential therapeutic target for kidney disease.Clinical hypertension · 2023Review
- Review
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5 authors at 1 institution in 1 country.
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Abstract
Elevated nocturnal blood pressure (BP) and nocturnal non-dipping are frequently observed in patients with chronic kidney disease (CKD) and are stronger predictors of cardiovascular complications and CKD progression than standard office BP. The sympathetic nervous system (SNS) is thought to modulate diurnal hemodynamic changes and the vascular endothelium plays a fundamental role in BP regulation. We hypothesized that SNS overactivity and endothelial dysfunction in CKD are linked to elevated nocturnal BP and non-dipping. In 32 CKD patients with hypertension (56 ± 7 years), office BP, 24-hr ambulatory BP, muscle sympathetic nerve activity (MSNA) and endothelial function via flow-mediated dilation (FMD) were measured. Participants were subsequently divided into dippers (nighttime average BP > 10% lower than the daytime average BP, n = 8) and non-dippers (n = 24). Non-dippers had higher nighttime BP (p < .05), but not office and daytime BP, compared to dippers. MSNA burst incidence (81 ± 13 versus 67 ± 13 bursts/100 HR, p = .019) was higher and brachial artery FMD (1.7 ± 1.5 versus 4.7 ± 1.9%, p < .001) was lower in non-dippers compared to dippers. MSNA and FMD each predicted nighttime systolic (β = 0.48,-0.46, p = .02, 0.07, respectively) and diastolic BP (β = 0.38,-0.47, p = .04, 0.03, respectively) in multivariate-adjusted analyses. Our novel findings demonstrate that unfavorable nocturnal BP profiles are associated with elevated SNS activity and endothelial dysfunction in CKD. Specifically, CKD patients with higher nighttime BP and the non-dipping pattern have higher MSNA and lower FMD. These support our hypothesis that SNS overactivation and endothelial dysfunction are linked to the dysregulation of nighttime BP as well as the magnitude of BP lowering at nighttime in CKD.
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