Diurnal blood pressure variation and related behavioral factors

Abstract

Blood pressure (BP) varies according to many internal and external factors, and behavioral factors have an important role in diurnal BP variation. BP rises sharply on waking in the morning and falls during sleep at night, although it varies throughout the day and night. These changes in BP are closely related to mental and physical activities, and the sympathetic nervous system mainly contributes to the diurnal variation in BP. Other behavioral factors, such as food consumption and obesity, dietary intake of sodium, drinking and smoking habits, consumption of coffee and tea, and bathing, also affect the diurnal variation in BP. Alterations in diurnal BP variation due to behavioral factors are frequently seen in patients with hypertension and can be classified as morning hypertension, daytime hypertension and nighttime hypertension. Appropriate lifestyle modifications may normalize or improve both the level and rhythm of BP in these patients. Hypertension Research (2011) 34, 281-285; doi:10.1038/hr.2010.241; published online 2 December 2010Keywords: ambulatory blood pressure monitoring; diurnal blood pressure variation; lifestyle; mental stress; physical activity INTRODUCTION Blood pressure (BP) varies according to many internal and external factors. There are several distinctive rhythmic variations in BP including diurnal (or circadian) variation, and behavioral factors have an important role in diurnal BP variation. BP rises sharply on waking in the morning and falls during sleep at night, although it varies with changes in mental and physical activities during daytime and nighttime. [1][2][3][4] In addition to the awake and sleep cycle, many behavioral factors, such as mental stress, exercise, food consumption, changes in body weight, dietary intake of sodium and other electrolytes, drinking and smoking habits, consumption of coffee and tea, and bathing, influence both the level and variation in BP. [5][6][7][8] Understanding the influences of those behavioral factors on diurnal BP variation is important for the management of hypertension because alterations in diurnal BP variation due to behavioral factors are observed in many hypertensive subjects. 9,10 It has been shown that ambulatory BP monitoring is useful for assessing the influence of behavioral factors as well as the effects of lifestyle modifications on the level and pattern of BP throughout the day. 11,12 In this review article, I would like to summarize the effects of behavioral factors on diurnal BP variation with respect to the pathophysiology of hypertension and the effects of lifestyle modifications on 24-h BP.

Association of home blood pressure variability with progression of chronic kidney disease

“…Although increased HBP variability might reflect the disease state, physiological or behavioral factors may also influence HBP variability. These factors, including waking and sleep cycles, mental and physical stress, temperature and alcohol intake, can affect diurnal BP variability, and may also be associated with HBP variability [22,23,31,32]. In addition, the quality of HBP measurements is not uniform, and artificial factors related to BP measurements, such as a time of resting before measurement, posture, or cuff placement, might be associated with variability.…”

Evening Chronotype Is Associated With Metabolic Disorders and Body Composition in Middle-Aged Adults

“…Blood pressure differences could be explained by diurnal rhythm of systemic blood pressure, dipping at night (behavioral sleep period) and surging at the time of waking in the morning (45). In KoGES, blood pressure is typically measured between 8 AM and noon.…”

Association between visit-to-visit clinic blood pressure variability and home blood pressure variability in patients with chronic kidney disease

“…8,[24][25][26][27][28][29] In addition, various physiological or behavioral factors, including waking and sleep cycles, mental and physical stress, temperature, and alcohol intake can affect both HBPV and VVV. [30][31][32][33][34] Previous studies have shown the factors affecting HBPV, including older age, female gender, high HBP and alcohol intake. 25,[30][31][32] The factors affecting VVV were almost similar to those affecting HBPV in several studies, including older age, female gender, high mean systolic clinic BP and history of myocardial infarction.…”