Evidence Based Medicine: Ambulatory blood pressure monitoring in stroke survivors: What do we add to the care of our patients?

Why is it necessary to know about the circadian blood pressure rhythm in acute stroke patients? Hypertension is a major reversible risk factor for stroke in all age groups. The biphasic circadian blood pressure (BP) pattern with physiological nocturnal decrease of 10-15 % in the BP is referred to as Dipping. This rhythm is lost in chronic hypertension and stroke. Absence of normal dipping results in a higher 24 hour blood pressure load and may lead to more target organ damage like left ventricular hypertrophy or recurrent stroke. Moreover, sleep systolic and early morning systolic BP (SBP) are more predictive for stroke events than daytimeSBP, especially in the elderly.