24-hour blood pressure monitoring: Basics and clinical applications in neurology

Indirect discontinuous ambulatory 24-h blood pressure monitoring is a non-i nvasive valid and reproducible method yielding insight into the circadian r hythm of arterial blood pressure. Initially developed for diagnosis and the rapy control of arterial hypertension, there are interesting indications fo r the use in neurologic diseases, e.g, in the examination of autonomic dysf unction (orthostatic or postprandial hypotension) in patients suffering fro m Parkinson's disease, multiple system atrophy or autonomic diabetic neurop athy. In these patients the disappearance of a circadian blood pressure rhy thm with increased blood pressure values during the night points to conside rable vegetative involvement. Nocturnal blood pressure rises as a sign of i ncreased sympathetic activity may also be found in sleep apnoea or certain kinds of cerebral infarction.