Circadian Variation of the Blood Pressure in the Population at Large
Ambulatory blood pressure (ABP) measurement has several advantages. ABP readings are obtained outside the medical environment and are free of the so-called “white coat” effect (1,2), often seen when the BP is conventionally measured. Therefore, the average BP level on ABP measurement provides a better estimate of a subject’s usual BP than conventional readings (3). In addition, the BP is recorded during the habitual daily activities, both working and resting periods, and during episodes of emotional stress and sleep. The way in which a subject’s BP is modulated throughout the day to cope with these various levels of physical and emotional activity and so forth may provide meaningful pathophysiological information (4). Some investigators have also speculated that the amplitude of the diurnal BP profile is characteristic for an individual (5), or that a blunted or absent nocturnal fall in BP is correlated with a worse cardiovascular prognosis (4). These views explain the growing interest in methods to describe the diurnal BP profile and its determinants.
KeywordsAmbulatory Blood Pressure Ambulatory Blood Pressure Monitoring Circadian Variation Ambulatory Blood Pressure Measurement Diurnal Blood Pressure
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- 2.Pickering TG, James GD, Boddie C, Harshfield GA, Blank S, Laragh JH. How common is white coat hypertension? JAMA 1988;259:225–228.Google Scholar
- 3.The Scientific Committee. Concensus document on non-invasive ambulatory blood pressure monitoring. J Hypertens 1990;8:135–140.Google Scholar
- 4a.Raferty EB. Understanding hypertension: the contribution of direct ambulatory blood pressure monitoring. In: Weber MA, Drayer JIM, eds. Ambulatory Blood Pressure Monitoring. Springer-Verlag, New York, 1983, pp. 105–116.Google Scholar
- 7.Fagard RF, Staessen JA, Thijs L. Optimal definition of daytime and night-time blood pressure. Blood Pressure Monit 1997;2:315–321.Google Scholar
- 9.Staessen JA, Fagard R, Thijs L, Amery A. Fourier analysis of blood pressure profiles. Am J Hypertens 1993;6:184S–187S.Google Scholar
- 10.Fagard R, Staessen JA, Thijs L. Twenty-four-hour blood pressure measurements: analytic aspects. Blood Pressure Monit 1996;1:S23–S25Google Scholar
- 11.Staessen JA, Atkins N, Fagard R, et al. Correlates of the diurnal blood pressure profile in a population study. High Blood Pressure 1993;2:271–282.Google Scholar
- 15.Middeke M, Kluglich M. Gestorte nachtliche Blutdruckregulation by Hypertoniken im hoheren Lebensalter. Geriat Forsch 1995;3:125–132.Google Scholar
- 16.Imai Y, Munakata M, Hashimoto J, et al. Age-specific characteristics of nocturnal blood pressure in a general population in a community of Northern Japan. Am J Hypertens 1993;6: 179S–183S.Google Scholar
- 18.Zhang W, Shi H, Wang R, et al. Reference values for the ambulatory blood pressure: results from a collaborative study. Chin J Cardiol 1995;10:325–328.Google Scholar