Mercer's Institute for Successful Ageing, St James's Hospital, Dublin 8, Ireland.
Int J Stroke. 2011 Oct;6(5):388-91. doi: 10.1111/j.1747-4949.2011.00593.x. Epub 2011 Apr 18.
BACKGROUND/AIMS: Abnormalities in nocturnal blood pressure control identified using ambulatory blood pressure monitoring are associated with adverse cardiovascular outcomes. Sleep and wake episodes during such studies are usually identified by means of sleep diaries but these may be inaccurate in stroke patients. We performed a study to determine whether sleep-wake data obtained using wrist-mounted actimeters would significantly influence the results of routinely performed nocturnal ambulatory blood pressure monitoring when compared with diary-based sleep-wake recording and fixed time-period data.
Actimetry was performed using a wrist-mounted device during routine ambulatory blood pressure monitoring in subjects who had suffered a transient ischaemic attack or stroke. The mean nocturnal blood pressure readings were calculated using sleep data derived from actimetry and diaries and compared for a fixed time period from 11:00 pm to 8:00 am.
Twenty subjects (mean age 68 years, and 13 female) were studied. Patients were found to have slept for a median of six-hours (one- to eight-hours) by diary and five-hours (zero- to eight-hours) by actimeter data. Diary and actimeter data agreed in 69% of recordings. The mean sleeping systolic blood pressure was lower when calculated by actimeter data than by diary data (119·6 mmHg vs. 123·2 mmHg, P=0·049, paired t-test) but there was no significant difference in diastolic blood pressure. The mean nocturnal blood pressure calculated from 11:00 pm to 7:00 am was higher than sleeping blood pressure calculated from diary data. (mean systolic blood pressure: 127·6 mmHg vs. 123·6 mmHg, P=0·065; mean diastolic blood pressure 69·0 vs. 64·0, P=0·028).
Calculation of nocturnal and sleeping blood pressure is lower in subjects with stroke and transient ischaemic attack when objective actimeter-derived sleep/wake data are used.
背景/目的：使用动态血压监测识别的夜间血压控制异常与不良心血管结局相关。在这些研究中，睡眠和觉醒期通常通过睡眠日记来识别，但在中风患者中这些可能不准确。我们进行了一项研究，以确定与基于日记的睡眠-觉醒记录和固定时间段数据相比，使用腕戴式活动计获得的睡眠-觉醒数据是否会显著影响常规进行的夜间动态血压监测的结果。
在短暂性脑缺血发作或中风患者进行常规动态血压监测期间，使用腕戴式设备进行活动计测量。使用活动计和日记得出的睡眠数据计算夜间平均血压读数，并比较从晚上 11 点到早上 8 点的固定时间段的数据。
研究了 20 名受试者（平均年龄 68 岁，13 名女性）。根据日记，患者睡眠时间中位数为六小时（一至八小时），根据活动计数据为五小时（零至八小时）。日记和活动计数据在 69%的记录中一致。通过活动计数据计算得出的平均睡眠收缩压低于通过日记数据计算得出的结果（119.6mmHg 与 123.2mmHg，P=0.049，配对 t 检验），但舒张压无显著差异。从晚上 11 点到早上 7 点计算的平均夜间血压高于从日记数据计算得出的睡眠血压。（平均收缩压：127.6mmHg 与 123.6mmHg，P=0.065；平均舒张压 69.0 与 64.0，P=0.028）。
当使用客观的活动计衍生的睡眠/觉醒数据时，中风和短暂性脑缺血发作患者的夜间和睡眠血压计算值较低。
