Ambulatory Blood Pressure Monitoring for Evaluating the Relationships Between Lifestyle, Hypertension and Cardiovascular Risk

Abstract

1. Ambulatory monitoring provides a unique opportunity for studying the temporal relationships between lifestyle factors and blood pressure (BP). These include physical activity, mental activity, environmental stressors, substances ingested for pleasure such as smoking, alcohol and caffeine, and nutrition. 2. Changes in physical activity play a major role in determining the diurnal profile of BP, whereas the influence of mood is small. 3. Environmental stress, in the form of job strain, has been shown to be associated with a sustained increase of BP throughout the day and night in men, and also with an increased left ventricular mass. The effects are most marked in men who drink alcohol regularly. Job strain does not appear to influence BP in women. 4. Although it is recognized that smoking raises BP acutely, its long-term effects have been unclear. Ambulatory monitoring shows that smokers have a larger diurnal swing of BP than non-smokers, because of a higher daytime pressure. Alcohol also increases the diurnal swing of BP. 5. Ambulatory monitoring has been used relatively little for evaluating nutritional factors, but has the possibility of quantifying their effects on BP more reliably than traditional methods, and also elucidating the underlying mechanisms.

Is There a Temporal Pattern in the Occurrence of Subarachnoid Hemorrhage in the Southern Hemisphere?

“…On the other hand, the absence of a circaseptan pattern in the occurrence of SAH and a substantial risk of an event during working hours and late afternoon are suggestive of differences in circadian triggering factors for this disorder as opposed to other stroke subtypes and myocardial infarction. Because blood pressure levels exhibit similar diurnal fluctuations, with an increase on awakening and during working activity, 11,12,[32][33][34][35][36] an increase in blood pressure may be a factor for aneurysm formation and/or rupture (in our study, Ϸ75% of patients had proven aneurysm rupture as the cause for SAH). Increased exposure to smoking, physical activity, and alcohol while awake have been shown 11,12,32,35 to be associated with an elevation in blood pressure and may trigger rupture of a critically weakened aneurysm wall.…”

“…The risk of SAH during wakening hours was more pronounced in younger men and older women, although the differences were not statistically significant. This may be related to differences in variability of blood pressure and exposure to lifestyle/environmental factors, such as smoking 11,32 and physical activity, 35 between the groups. Hemorrhages that did not waken the person or were not apparent until morning were considered to have occurred at the time of awakening.…”

Cigarette smoking, proteinuria, and renal function in middle-aged Japanese men from an occupational population

“…Also, a lower blood pressure in current smokers, which persists after adjusting for the lower body weight, has been observed in many epidemiological studies [23,24]. However, it cannot be said that smokers really have a lower blood pressure than nonsmokers because ambulatory monitoring studies on blood pressure in smokers have often shown a rather higher blood pressure than in nonsmokers [25,26]. Smoking causes an acute rise of blood pressure.…”

Impact of Shift Work and Race/Ethnicity on the Diurnal Rhythm of Blood Pressure and Catecholamines

“…The diurnal fluctuations of some biological parameters are dependent on endogenous circadian rhythms and thus resistant to changes in the cycle of activity and sleep. 1 We and others have shown that physical and mental activity play an important role in determining the diurnal BP rhythm. [2][3][4][5][6][7][8][9][10] The effects of shift work on BP have been examined using ambulatory blood pressure (ABP) monitoring in a few studies.…”