Document Detail

Circadian time-qualified tolerance intervals for ambulatory blood pressure monitoring in the diagnosis of hypertension.
MedLine Citation:
PMID:  15129829     Owner:  NLM     Status:  MEDLINE    
The large-amplitude circadian pattern in blood pressure of healthy subjects of both genders suggests that the constant threshold currently used to diagnose hypertension should be replaced by a time-specified reference limit reflecting the mostly predictable blood pressure variability during the 24 h. Accordingly, we derived circadian time-specified reference standards for blood pressure as a function of gender. We studied 743 normotensive Caucasian volunteers (400 men and 343 women), 45.7 +/- 16.5 (mean +/- SD) years of age. Blood pressure was measured by ambulatory monitoring at 20-min intervals during the day and at 30-min intervals at night for 48 consecutive hours. Data from each blood pressure series were synchronized according to the rest-activity cycle of each individual in order to avoid differences among subjects in actual times of daily activity. Data were then used to compute 90% circadian tolerance intervals for each gender separately. The method, derived on the basis of bootstrap techniques, does not need to assume normality or symmetry in the data and, therefore, it is highly appropriate to describe the circadian pattern of blood pressure variability. Results reflect expected changes in the tolerance limits as a function of gender and circadian sampling time, as well as upper blood pressure limits below the thresholds currently used for diagnosing hypertension, especially for women. The use of these time-dependent tolerance limits for the computation of a hyperbaric index as a measure of blood pressure excess has already been shown to provide a reproducible and high-sensitivity test for the diagnosis of hypertension, which can also be used to evaluate treatment efficacy.
Ramón C Hermida; José R Fernández; Diana E Ayala; Artemio Mojón; Ignacio Alonso; Carlos Calvo
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chronobiology international     Volume:  21     ISSN:  0742-0528     ISO Abbreviation:  Chronobiol. Int.     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2004-05-07     Completed Date:  2004-11-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8501362     Medline TA:  Chronobiol Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  147-60     Citation Subset:  IM    
Bioengineering Laboratory, University of Vigo, Campus Universitario, Vigo, Spain.
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MeSH Terms
Blood Pressure / physiology
Blood Pressure Monitoring, Ambulatory*
Circadian Rhythm / physiology*
Heart Rate / physiology
Hypertension / diagnosis*,  physiopathology*
Middle Aged

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