Age-Related Differences of Blood Pressure Profile in Essential Hypertension

Scorzoni, Daniela; Bazzanini, F; Brunazzi, Maria Cristiana; Chirilto, Fabio; Biondi, P.; Hölzl, Anna; Musacci, G. F.; Longhini, C

doi:10.3109/07420529709001460

Cited by 9 publications

(8 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Jones et al (2006) also observed a further fall and rise in systolic blood pressure reactivity in the afternoon. This finding agrees with other observations on elderly people, including those with hypertension, of a secondary rise in blood pressure in the afternoon, especially after a nap is taken (Atkinson et al 1994;Dunbar & Farr 1996;Kawamura et al 2003;Scorzoni et al 1997). Since some cardiac events also show a secondary peak in the late afternoon or evening, these blood pressure changes have led to the hypothesis that daytime sleep or a ''siesta'' is also a significant risk factor for myocardial infarction and strokes (Bursztyn et al 1999(Bursztyn et al , 2002Campos & Siles 2000;Qureshi et al 1997).…”

Section: Quantitative Descriptions Of Heart Rate and Blood Pressure Datasupporting

confidence: 90%

Chronophysiology of the cardiovascular system

Waterhouse

Atkinson

Reilly

et al. 2007

Biological Rhythm Research

View full text Add to dashboard Cite

The development of ambulatory blood pressure monitoring devices and the beat-by-beat measurement of heart rate have enabled it to be established that there are circadian rhythms in heart rate and blood pressure in subjects living normally. Investigations of these variables have led to quantification of their fall at night, and rapid rise on awakening and becoming active in the morning. These changes are of particular interest insofar as abnormalities in them are associated with cardiovascular problems and morbidity in patients and also act as risk factors in otherwise healthy individuals. It has also been shown that there are many other variables of the cardiovascular system. The causes of the circadian rhythms in heart rate and blood pressure are outlined, with particular stress upon the role of the autonomic nervous system, as assessed from low-and high-frequency components of the variation in heart rate measured beat-by-beat. Activity increases blood pressure, but there is evidence that this ''reactivity'' varies with time of day, and this also might be related to cardiovascular morbidity. Based upon data from several sources, including night work, resting subjects and bed-ridden patients, it is concluded that the contribution of the ''body clock'' to producing the circadian rhythm in heart rate and blood pressure is relatively small. A bias towards an exogenous cause applies also to most other circadian rhythms in the cardiovascular system. Knowledge of circadian rhythmicity in cardiovascular system, together with an understanding of its causes, provides a rationale for advice to reduce cardiovascular risk and to assess the efficacy of therapies.

show abstract

Section: Quantitative Descriptions Of Heart Rate and Blood Pressure Datasupporting

confidence: 90%

Chronophysiology of the cardiovascular system

Waterhouse

Atkinson

Reilly

et al. 2007

Biological Rhythm Research

View full text Add to dashboard Cite

show abstract

“…For example, a secondary fall and rise in BP has been demonstrated in the afternoon in the elderly, including those who are hypertensive. 9,10 This pattern is also observed in people who take an afternoon "siesta." 11 Interestingly, the siesta has been identified as a separate risk factor for sudden cardiac events, 12 but it is not known whether it is the daytime sleep, the increase in activity after the nap, or both components that mediate unfavorable BP changes.…”

mentioning

confidence: 62%

Reactivity of Ambulatory Blood Pressure to Physical Activity Varies With Time of Day

et al. 2006

View full text Add to dashboard Cite

Abstract-Blood pressure (BP) fluctuates over a 24-hour period, but it is unclear to what extent this variation is governed completely by changes in physical activity. Our aim was to use a BP "reactivity index" to investigate whether the BP response to a given level of physical activity changes during a normal sleep-wake cycle. Hypertensive patients (nϭ440) underwent simultaneous 24-hour ambulatory BP, heart rate (HR), and activity monitoring. BP and HR were measured every 20 minutes. Actigraphy data were averaged over the 15 minutes that preceded a BP measurement. Individual BP and HR reactivity indices were calculated using least-squares regression for twelve 2-hour periods. These indices were then analyzed for time-of-day differences using a general linear model. Systolic BP and HR were generally more reactive to physical activity than diastolic BP. The highest reactivity of systolic BP (meanϮSEϭ4Ϯ1 mm Hg per logged unit change in activity) was observed between 8:00 AM and 10:00 AM (Pϭ0.014). Between 10:00 AM and 12:00 PM, BP reactivity then decreased (Pϭ0.048) and showed a secondary rise in the early afternoon. These 24-hour changes in BP reactivity did not differ significantly between groups formed on the basis of early and late wake times (Pϭ0.485), medication use, age, and sex (PϾ0.350). In conclusion, under conditions of normal living, the reactivity of BP and HR to a given unit change in activity is highest in the morning and shows a secondary rise in the afternoon.

show abstract

“…16,17 Recently, however, a second daytime BP peak, occurring in the afternoon, has been identified 6,18 by Scorzoni et al in 34 hypertensive individuals. 18 This was confirmed by Jones et al in 440 hypertensive patients. 6 We also have previously observed an afternoon BP peak in 64 normotensive type 2 DM patients.…”

Section: Discussionmentioning

confidence: 71%