Major depression has a negative influence on the course and outcome of cardiovascular events. It has been proposed that this association could be explained by higher risk of development of high blood pressure, but studies have produced conflicting results.

Although there is no definitive evidence of an association between depression and development of hypertension, depression can impair the management and prognosis of hypertension through several potential mechanisms.

Circadian profile of blood pression has been studied as a predictive factor of outcome in hypertensive patients. Studies suggest that non-dipping pattern of blood pressure is associated with worse outcome in these patients.

Non dipping pattern of blood pressure has been studied in patients with sleep disorders and it could be associated with reduction of stage 4 sleep and higher percentage of time awake after sleep onset. Sleep disturbances are one of the diagnostic symptoms of major depression and polisomnographic abnormalities have been showed in these patients.

The aim of this work is to review the influence of major depression on hypertension course and prognosis, focusing on the circadian profile of blood pressure.