Individual Differences in Ambulatory Blood Pressure Patterns

  • Gregory A. Harshfield
  • Derrick A. Pulliam
Part of the Perspectives on Individual Differences book series (PIDF)


The development of ambulatory blood pressure (ABP) monitoring has provided the behavioral scientist with a methodology to identify and study factors responsible for individual differences in systolic (S) and diastolic (D) blood pressure (BP) in the natural environment. Although ABP monitoring does not give the investigator the control over experimental conditions offered by traditional laboratory testing, it does provide a means to study the individual as he or she responds to the physical and psychological demands that they normally encounter during the day. Furthermore, ABP monitoring provides a method to study the influence of these demands on systems that are important for the long-term regulation of BP, such as the renin-angiotensin system and the hypothalamo-pituitary-adrenal system.


Ambulatory Blood Pressure Sodium Excretion Ambulatory Blood Pressure Monitoring Primary Aldosteronism Blood Pressure Variability 
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  1. Asmar, R. G., Brunei, P. C., Pannier, B. M., Lacolley, P. J., & Safer, M. E. (1988). Arterial distensibility and ambulatory blood pressure monitoring in essential hypertension. American Journal of Cardiology, 61, 1066–1070.PubMedCrossRefGoogle Scholar
  2. Baumgart, P., Walger, P., Dorst, K. G., Eiff, M. V., Rahn, K. H., & Vetter, H. (1989a). Can secondary hypertension be identified by twenty-four-hour ambulatory pressure monitoring? Journal of Hypertension, 7(3), S25–S28.PubMedGoogle Scholar
  3. Baumgart, P., Walger, P., Fuchs, G., Dorst, K. G., Vetter, H., & Rahn, K. H. (1989b). Twentyfour-hour blood pressure is not dependent on endogenous circadian rhythm. Journal of Hypertension, 7, 331–334.PubMedCrossRefGoogle Scholar
  4. Bevan, A. T., Honour, A. J., & Stott, F. (1969). Direct arterial pressure reading in unrestricted man. Clinical Science, 86, 329–344.Google Scholar
  5. Brunner, H. R., Waeber, B., & Nussberger, J. (1985). Clinical use of non-invasive ambulatory blood pressure recording. Journal of Hypertension, 3(2), S13–S17.PubMedGoogle Scholar
  6. Chau, N. P., Mallion, J. M., Gaudemaris, R. D., Ruche, E., Siche, J. P., Pelen, O., & Mathern, G. (1989). Twenty-four-hour ambulatory blood pressure in shift workers. Circulation, 80, 341–347.PubMedCrossRefGoogle Scholar
  7. Chau, N. P., Chanudet, X., & Larroque, P. (1990). Inverse relationship between upright plasma renin activity and 24-hour blood pressure variability in borderline hypertension. Journal of Hypertension, 8, 913–918.PubMedCrossRefGoogle Scholar
  8. Clark, L. A., Denby, L., Pregibon, D., Harshfield, G. A., Pickering, T. G., Blank, S., & Laragh, J. H. (1987). The effects of activity and time of day on the diurnal variations of blood pressure. Journal of Chronic Disease, 40, 671–681.CrossRefGoogle Scholar
  9. De Guademaris, R., Mallion, J. M., Battistella, P., Battistella, B., Siche, J. P., Blatier, J. F., & Francois, M. (1987). Ambulatory blood pressure and variability by age and sex in 200 normotensive subjects: Reference population values. Journal of Hypertension, 5, S429–S430.Google Scholar
  10. Drayer, J. I. M., Weber, M. A., DeYoung, J. L., & Wyle, F. A. (1982). Circadian blood pressure patterns in ambulatory hypertensive patients. American Journal of Medicine, 73, 493–499.PubMedCrossRefGoogle Scholar
  11. Egger, M., Bianchetti, M. G., Gnadinger, M., Kobelt, R., & Oetliker, O. (1987). Twenty four hour intermittent, ambulatory blood pressure monitoring. Archives of Diseases in Childhood, 62, 1130–1135.CrossRefGoogle Scholar
  12. Falkner, B. (1990). Differences between blacks and whites with essential hypertension: Biochemistry and endocrine. Hypertension, 15, 681–686.PubMedCrossRefGoogle Scholar
  13. Falkner, B., Kushner, H., Khalsa, D. K., Canessa, M., & Katz, S. (1986). Sodium sensitivity, growth and family history of hypertension in young blacks. Journal of Hypertension, 4(5), S381–S383.PubMedGoogle Scholar
  14. Floras, J. S., Hassan, M. O., Jones, J. V., & Sleight, P. (1987). Pressor response to laboratory stresses and daytime blood pressure variability. Journal of Hypertension, 5, 715–719.PubMedCrossRefGoogle Scholar
  15. Giaconi, S., Levanti, C., Fommei, E., Innocenti, F., Seghieri, G., Palla, L., Palombo, C., & Ghione, S. (1989). Microalbuminuria and casual and ambulatory blood pressure monitoring in normotensives and in patients with borderline and mild essential hypertension. American Journal of Hypertension, 2, 259–261.PubMedGoogle Scholar
  16. Guyton, A. C. (1986). Textbook of medical physiology. (7th ed.). Philadelphia: W. B. Saunders.Google Scholar
  17. Guyton, A. C. (1987). Renal function curve—A key to understanding the pathogenesis of hypertension. Hypertension, 10, 1–6.PubMedCrossRefGoogle Scholar
  18. Hall, J. E., Guyton, A. C., Coleman, T. G., Woods, L. L., & Mizelle, H. L. (1987). Renal excretory function and hypertension. In N. Kaplan, B. Brenner, & J. Laragh (Eds.), The kidney in hypertension (pp. 1–19). New York: Raven Press.Google Scholar
  19. Harshfield, G. A., Pickering, T. G., Kleinert, H. D., Blank, S., & Laragh, J. H. (1982). Situational variations of blood pressure in ambulatory hypertensive patients. Psychosomatic Medicine, 44, 237–245.PubMedGoogle Scholar
  20. Harshfield, G. A., Pickering, T. G., Blank, S. G., & Laragh, J. H. (1986). How well do casual blood pressures reflect ambulatory blood pressures? In G. Germano (Ed.), Blood pressure recording in the clinical management of hypertension (pp. 50–54). Rome: Edizion L Pozzi.Google Scholar
  21. Harshfield, G. A., Alpert, B. S., Willey, E. S., Somes, G. W., Murphy, J. K., & Dupaul, L. M. (1989). Race and gender influence ambulatory blood pressure patterns of adolescents. Hypertension, 14, 598–603.PubMedCrossRefGoogle Scholar
  22. Harshfield, G. A., Dupaul, L. M., Alpert, B. S., Christman, J. V., Willey, E. S., Murphy, J. K., & Somes, G. W. (1990a). Aerobic fitness and the diurnal rhythm of blood pressure in adolescents. Hypertension, 15, 810–814.PubMedCrossRefGoogle Scholar
  23. Harshfield, G. A., Hwang, C., & Grim, C. E. (1990b). Circadian variation of blood pressure in blacks: Influence of age, gender and activity. Journal of Human Hypertension, 4, 43–47.PubMedGoogle Scholar
  24. Harshfield, G. A., Pulliam, D. A., Alpert, B. S., Stapleton, F. B., Willey, E. S., & Somes, G. W. (1990c). Renin-sodium profiles influence ambulatory blood pressure patterns in children and adolescents. Pediatrics, 87, 94–100.Google Scholar
  25. Harshfield, G. A., Pickering, T. G., James, G. D., & Blank, S. G. (1990d). Blood pressure variability and reactivity in the natural environment. In W. Meyer-Sabellek, M. Anlauf, R. Gotzen, & L. Steinfeld (Eds.), Blood pressure measurements: New techniques in automatic and 24-hour indirect monitoring (pp. 241–251). Darmstadt: Steinkopff-Verlag.CrossRefGoogle Scholar
  26. Harshfield, G. A., Alpert, B. S., Pulliam, D. A., Willey, E. S., Somes, G. W., & Stapleton, B. F. (1991). Electrolyte excretion and racial differences in nocturnal blood pressure. Hypertension, 18, 813–818.PubMedCrossRefGoogle Scholar
  27. Horan, M. J., Kennedy, H. L., & Padgett, N. E. (1981). Do borderline hypertensive patients have labile blood pressure?. Annals of Internal Medicine, 94, 466–468.PubMedCrossRefGoogle Scholar
  28. Imai, Y., Abe, K., Miura, Y., Nihei, M., Sasaki, S., Minami, N., Munaka, M., Taira, N., Sekino, H., Yamakoshi, K., & Yoshinaga, K. (1988a). Hypertensive episodes and arcadian fluctuations of blood pressure in patients with phaeochromocytoma: Studies by long-term blood pressure monitoring based on a volume-oscillometric method. Journal of Hypertension, 6, 9–15.PubMedCrossRefGoogle Scholar
  29. Imai, Y., Abe, K., Sasaki, S., Minami, N., Nihei, M., Munakata, M., Murakami, O., Matsue, K., Sekino, H., Miura, Y., & Yoshinga, K. (1988b). Altered circadian blood pressure rhythm in patients with Cushing’s syndrome. Hypertension, 12, 11–19.PubMedCrossRefGoogle Scholar
  30. James, G. D. (1990). The independent effects of race and stress on the diurnal variation of blood pressure in women. American Journal of Hypertension, 3(5, part 2), 33A.Google Scholar
  31. James, G. D., Yee, L. S., Harshfield, G. A., Blank, S. G., & Pickering, T. G. (1986). The influence of happiness, anger, and anxiety on the blood pressure of borderline hypertensives. Psychosomatic Medicine, 48(7), 502–508.PubMedGoogle Scholar
  32. Laragh, J. H. (1987). Role of the renin-angiotensin-aldosterone axis in human hypertensive disorders. In N. Kaplan, B. Brenner, & J. Laragh (Eds.), The kidney in hypertension (pp. 35–51). New York: Raven Press.Google Scholar
  33. Littler, W. A., & Honour, A. J. (1974). Direct arterial pressure, heart rate, and electrocardiogram in unrestricted patients before and after removal of a phaeochromocytoma. Quarterly Journal of Medicine, 43, 441–449.PubMedGoogle Scholar
  34. Littler, W. A., West, M. J., Honour, A. J., & Sleight, P. (1978). The variability of arterial pressure. American Heart Journal, 95, 180–186.PubMedCrossRefGoogle Scholar
  35. Mancia, G., Parati, G., Pomidossi, G., Casadei, R., Groppelli, A., Sposato, E., & Zanchetti, A. (1985). Doctor-elicited blood pressure rises at the time of sphygmomanometric blood pressure assessment persist over repeated visits. Journal of Hypertension, 3(3), S4231–S423.Google Scholar
  36. Mann, S., Millar-Craig, M. W., Melville, D. I., Balasubramanian, V., & Raftery, E. B. (1979). Physical activity and the circadian rhythm of blood pressure. Clinical Science, 57, 291s–294s.PubMedGoogle Scholar
  37. Munakata, M., Imai, Y., Abe, K., Sasaki, S., Minami, N., Sekino, H., & Yoshinaga, K. (1988). Involvement of the hypothalamo-pituitary-adrenal axis in the control of circadian blood pressure rhythm. Journal of Hypertension, 6(4), S44–S46.PubMedGoogle Scholar
  38. Murphy, M. B., Nelson, K. S., & Elliott, W. J. (1988). Racial differences in diurnal blood pressure profile. American Journal of Hypertension, 1 (A), 55.Google Scholar
  39. Murphy, M. B., Lang, R. L., Nelson, K. S., Bednarz, J., & Elliott, W. J. (1990). Diurnal blood pressure differences are associated with inter-racial differences in cardiac hypertrophy. Journal of Human Hypertension, 4, 194.Google Scholar
  40. Opsahl, J. A., Abraham, P. A., Halstenson, C. E., & Keane, W. F. (1988). Correlation of office and ambulatory blood pressure measurements with urinary albumin and N-acetyl-glucosaminidase excretions. American Journal of Hypertension, 1, 117S–120S.PubMedCrossRefGoogle Scholar
  41. Pickering, T. G., & Gerin, (1988). Ambulatory blood pressure monitoring and cardiovascular reactivity testing for the evaluation of the role of psychosocial factors and prognosis in hypertensive patients. American Heart Journal, 116, 665–672.PubMedCrossRefGoogle Scholar
  42. Pickering, T. G., Harshfield, G. A., Kleinert, H. D., Blank, S., & Laragh, J. H. (1982). Comparisons of blood pressure during normal daily activities, sleep, and exercise in normal and hypertensive subjects. Journal of the American Medical Association, 247, 992–996.PubMedCrossRefGoogle Scholar
  43. Pickering, T. G., Harshfield, G. A., Devereux, R. B., & Laragh, J. H. (1985). What is the role of ambulatory blood pressure monitoring in the management of hypertensive patients? Hypertension, 7(2), 171–177.PubMedCrossRefGoogle Scholar
  44. Pickering, T. G., James, G. D., Boddie, C., Harshfield, G. A., Blank, S. G., & Laragh, J. H. (1988). How common is white coat hypertension?. Journal of the American Medical Association, 259, 225–228.PubMedCrossRefGoogle Scholar
  45. Reeves, R. A., Shapiro, A. P., Thompson, M. E., & Johnson, A. M. (1986). Loss of nocturnal decline in blood pressure after cardiac transplantation. Circulation, 73, 401–408.PubMedCrossRefGoogle Scholar
  46. Rowlands, D. B., Stallard, T. J., Watson, R. D. S., & Littler, W. A. (1980). The influence of physical activity on arterial pressure during ambulatory recordings in man. Clinical Science, 58, 115–117.PubMedGoogle Scholar
  47. Southard, D. R., Coates, T. J., Kolodner, K., Parker, F. C., Padgett, N. E., & Kennedy, H. L. (1986). Relationship between mood and blood pressure in the natural environment: An adolescent population. Health Psychology, 5(5), 469–480.PubMedCrossRefGoogle Scholar
  48. Sundberg, S., Kohvakka, A., & Gordin, A. (1988). Rapid reversal of circadian blood pressure rhythm in shift workers. Journal of Hypertension, 6, 393–396.PubMedCrossRefGoogle Scholar
  49. Tanaka, T., Natsume, T., Shibata, H., Nozawa, K., Kojima, S., Tsuchiya, M., Ashida, T., & Ikeda, M. (1983). Circadian rhythm of blood pressure in primary aldosteronism and renovascular hypertension: Analysis by the cosinor method. Japanese Circulation Journal, 47, 788–794.PubMedCrossRefGoogle Scholar
  50. Van Egeren, L. F., & Madarasmi, S. (1988). A computer-assisted diary (CAD) for ambulatory blood pressure monitoring. American Journal of Hypertension, 1, 179S–185S.PubMedCrossRefGoogle Scholar
  51. Watson, R. D. S., Stallard, T. J., Flinn, R. M., & Littler, W. A. (1980). Factors determining direct arterial pressure and its variability in hypertensive men. Hypertension, 2, 333–341.PubMedCrossRefGoogle Scholar
  52. Weber, M. A., Drayer, J. I. M., Nakamura, D. K., & Wyle, F. (1984). The circadian blood pressure pattern in ambulatory normal subjects. American Journal of Cardiology, 54, 115–119.PubMedCrossRefGoogle Scholar
  53. Weinberger, M. H., Miller, J. Z., Luft, F. C., Grim, C. E., & Fineberg, N. (1986). Definitions and characteristics of sodium sensitivity and blood pressure resistance. Hypertension, 8 (II), II127–II134.PubMedGoogle Scholar
  54. White, W. B. (1986). Assessment of patients with office hypertension by 24-hour noninvasive ambulatory blood pressure monitoring. Archives of Internal Medicine, 146, 2196–2199.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1992

Authors and Affiliations

  • Gregory A. Harshfield
    • 1
  • Derrick A. Pulliam
    • 1
  1. 1.Department of PediatricsUniversity of TennesseeMemphisUSA

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