Ambulatory blood pressure in patients with mesangial proliferative glomerulonephritis

Twenty-four-hour ambulatory blood pressure was measured in seven normotensi ve and 10 hypertensive patients with biopsy proven mesangial proliferative glomerulonephritis (MPG). In normotensive patients, the nocturnal blood pre ssure variation was seen with a nightly drop in blood pressure while in hyp ertensive patients with MPG, 24-h blood pressure level was increased both a t day- and night-time, but a nocturnal change in blood pressure was also ob served in these patients. The pattern of blood pressure variation was not, however, different from the normotensive patients. None of the hypertensive patients with MPG was a so-called non-dipper, showing the same level of bl ood pressure both at day- and nighttime. The hypertensive patients had a ra pid increase in blood pressure in the early morning hours from 06.00 to 09. 00 h, followed by a relatively abrupt decrease in blood pressure in the eve ning hours. The patients with high blood pressure were treated with antihyp ertensive drugs; all patients started with captopril 25 mg once a day, late r increasing to twice daily. If the correction of the high blood pressure w as not achieved with this drug, amlodipine 5 or 10 mg was added with or wit hout furosemide. Most of the patients needed more than one drug. In all pat ients, a normal 24-h ambulatory blood pressure could be obtained. The lack of nightly non-dippers in the present hypertensive patients may be explaine d by a relatively short history of renal disease and the presence of normal or moderately reduced glomerular filtration rate. The abrupt rise in blood pressure during the early morning hours may be due to activation of the re nin-angiotensin or sympathetic nervous system in the hypertensive patients with MPG.