Chronic kidney disease (CKD) is a serious health problem affecting millions of people worldwide. In Asian populations, CKD may increase the risk of stroke, especially in younger individuals, making early detection and treatment crucial. Blood pressure (BP) control is an important part of CKD management, but recent studies suggest that nighttime BP may be even more important than daytime BP in predicting health risks.*

Nighttime Blood Pressure and Health Risks

One study in Asia found that nighttime BP is a strong predictor of health outcomes in CKD patients. The study, which included over 1,000 patients, showed that:

• Higher nighttime BP was linked to a greater risk of:
  • Heart disease,
  • Kidney failure, and
  • Death.
• Keeping nighttime systolic BP below 124 mmHg lowered the risk of heart problems.
• Levels below 110 mmHg were associated with better kidney health. 

These results suggest that monitoring nighttime BP can give doctors valuable information about a patient’s condition, even beyond regular 24-hour BP readings.

Another study, in Italy, found similar results, showing that nighttime BP was more closely tied to heart and kidney risks than daytime BP. Even though the two studies focused on different patient populations—one in Italy and one in Asia—their findings were the same: nighttime BP is an important factor in predicting CKD outcomes. This suggests that paying more attention to nighttime BP could improve care for CKD patients worldwide.

Challenges of Monitoring Nighttime BP

Despite its importance, nighttime BP monitoring is not easy to implement. The most reliable way to measure it is through ambulatory blood pressure monitoring (ABPM), which requires patients to wear a special device that takes BP readings throughout the night. 

ABPM devices are not widely available for home use, however, and many patients find it hard to sleep with the device, which can affect the accuracy of the readings. Another problem is that doctors still don’t have clear guidelines on how to treat high nighttime BP. Due to these challenges, nighttime BP monitoring is not used as often as it could be.

Future Solutions for Nighttime BP Monitoring

Moving forward, say researchers, scientists should focus on making nighttime BP monitoring more practical for everyday use. Cuffless devices, which use optical or sensor-based technology, are being explored, but they are not yet reliable enough for medical use.

More studies are also needed to understand how different populations respond to nighttime BP changes. If doctors can develop effective treatments for high nighttime BP and make monitoring easier, CKD patients could have better chances of avoiding serious heart and kidney problems.

*Satoh, M., Nobayashi, H., Nakayama, S. and Hirohito, M. (2025, February 19). Nighttime blood pressure in patients with chronic kidney disease: ambulatory blood pressure monitoring status in Japan and future implementation. Hypertension Research. https://www.nature.com/articles/s41440-025-02159-2 

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