Perez-Lloret Santiago, Risk Marcelo, Golombek Diego A, Cardinali Daniel P, Sanchez Ramiro, Ramirez Agustín
Physiology Department, School of Medicine, University of Buenos Aires, Argentina.
Chronobiol Int. 2008 Feb;25(1):99-113. doi: 10.1080/07420520801909403.
24 h and ultradian rhythms of blood pressure (BP) have been previously shown to be disorganized in nocturnal hypertensive subjects. The present study was undertaken to further analyze the ultradian and circadian BP rhythm structure in sleep-time hypertensive subjects with normal or elevated awake-time BP levels. Fourier analysis was used to fit 24, 12, 8, and 6 h curves to mean BP as well as heart rate (HR) time series data derived from 24 h ambulatory blood pressure monitoring. Awake and sleep periods were defined according to individual sleep diaries. Awake-time hypertension was defined as diurnal systolic (SBP) and/or diastolic BP (DBP) means > or =135/85 mmHg. Sleep-time hypertension was defined as nocturnal SBP and/or DBP means > or =120/70 mmHg. The sample included 240 awake-time normotensive subjects (180 sleep-time normotensives and 60 sleep-time hypertensives) and 138 untreated awake-time hypertensive subjects (31 sleep-time normotensives and 107 sleep-time hypertensives). The amplitude and integrity (i.e., percent rhythm) of the 24 and 12 h BP rhythms were lower in the sleep-time hypertensive subjects and higher in the awake-time hypertensive subjects. However, no differences were detected when the integrity and amplitude of the 6 and 8 h mean BP rhythms were analyzed. The sleep-time hypertensive group showed significantly higher 24 h BP rhythm acrophase variability. No differences could be found in any of the HR rhythm parameters. Altogether, the findings suggest a disorganization of the BP circadian rhythm in sleep-time hypertensives that results in reduced 24 h rhythm amplitude and integrity that could be related to cardiovascular risk.
先前已表明，夜间高血压患者的血压（BP）24小时及超日节律紊乱。本研究旨在进一步分析清醒时血压正常或升高的睡眠期高血压患者的超日和昼夜血压节律结构。采用傅里叶分析将24、12、8和6小时曲线拟合到平均血压以及从24小时动态血压监测获得的心率（HR）时间序列数据。根据个人睡眠日记定义清醒期和睡眠期。清醒时高血压定义为日间收缩压（SBP）和/或舒张压（DBP）平均值≥135/85 mmHg。睡眠时高血压定义为夜间SBP和/或DBP平均值≥120/70 mmHg。样本包括240名清醒时血压正常的受试者（180名睡眠时血压正常者和60名睡眠时高血压患者）和138名未经治疗的清醒时高血压患者（31名睡眠时血压正常者和107名睡眠时高血压患者）。睡眠时高血压患者的24小时和12小时血压节律的振幅和完整性（即节律百分比）较低，而清醒时高血压患者的则较高。然而，分析6小时和8小时平均血压节律的完整性和振幅时未发现差异。睡眠时高血压组的24小时血压节律尖峰相位变异性显著更高。在任何心率节律参数中均未发现差异。总之，研究结果表明睡眠期高血压患者的血压昼夜节律紊乱，导致24小时节律振幅和完整性降低，这可能与心血管风险有关。
