Management

Non-pharmacologic management

  • Do NOT lie down during the day
  • Elevate HOB by 6-9 inches
    • ↓ nocturnal diuresis from the high pressures the kidneys see
  • Nighttime meal/sweet snacks
    • Induce postprandial hypOtension

Pharmacologic management

  • 🔑 is timing of daytime pressor agents
    • Avoid pressor agents before bedtime (<4h)
    • Consider short-acting antihypertensive at bedtime
      • Captopril
      • Clonidine
      • Hydralazine
      • Losartan
      • Nitroglycerin patch