Bedtime Hypertension Treatment Increases Ambulatory Blood Pressure Control and Reduces Cardiovascular Risk in Resistant Hypertension

To the Editor: A cross-sectional 24-hour ambulatory blood pressure (BP) monitoring study1 reported 37.5% incidence of isolated office resistant hypertension (RH), there defined as clinic BP ≥140/90 mm Hg plus 24-hour BP mean 3 medications per day is true RH, regardless of BP values; exclusion of patients treated with ≥4 medications per day would decrease the reported prevalence to 24.6%; and, second, nocturnal hypertension and abnormal nondipper BP pattern are prevalent in RH1,2; current guidelines designate separate diagnostic thresholds for daytime and nighttime BP means; mean nighttime BP ≥120/70 …