Brito Leandro Campos de, Bowles Nicole P, McHill Andrew W, Rice Sean P M, Butler Matthew P, Emens Jonathan S, Shea Steven A, Thosar Saurabh S
Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, United States.
Oregon Health & Science University, Portland, United States.
Am J Physiol Heart Circ Physiol. 2023 Oct 20;325(6):H1394-9. doi: 10.1152/ajpheart.00542.2023.
Averaged nighttime blood pressure (BP) is superior to daytime BP for cardiovascular risk stratification, and the relative change between daytime/nighttime BP (dipping%) significantly predicts cardiovascular risk. Newer reports suggest that 4 measurements at night may be enough for cardiovascular risk stratification. Since BP oscillates across the night, the temporal distribution of measurements across the night may impact nighttime BP and dipping%. Therefore, we compared average nighttime BP and dipping% when using measurements in the first half (1-half), second (2-half), and a combination of both (combined).
Forty-three (17 females and twenty-six males) midlife adults aged 50±10 years old wore an ambulatory BP monitor for 24 hours at home, programmed to measure BP every 20 minutes when scheduled for daytime and every 30 minutes during a self-selected 8-hour nighttime for time-in-bed. We compared the nighttime BP averages and dipping% when using either the first four measurements from the 1-half or 2-half of the nighttime and combined.
Nighttime Systolic BP was significantly different across 1-half, 2-half, and combined (111±9 vs.107±11 vs. 109±9 mmHg, p<0.01), respectively, with significant pairwise differences across all categories (p<0.01 for each). Systolic BP dipping% was significantly different across 1-half, 2-half, and combined (9.9±5.5 vs.13.5±6.4 vs. 11.7±5.0 %, p<0.01), respectively, with significant pairwise differences across all categories (p<0.01 for each. Diastolic BP and diastolic dipping% were similar across the three different bins.
In midlife adults, systolic nighttime BP and dipping% may depend upon when BP measurements are taken during the night.
平均夜间血压在心血管风险分层方面优于日间血压，且日间/夜间血压的相对变化（血压下降百分比）能显著预测心血管风险。最新报告表明，夜间进行4次测量可能足以进行心血管风险分层。由于血压在夜间会波动，夜间测量的时间分布可能会影响夜间血压和血压下降百分比。因此，我们比较了在上半夜（前半段）、后半段以及两者结合（组合）进行测量时的平均夜间血压和血压下降百分比。
43名（17名女性和26名男性）年龄在50±10岁的中年成年人在家中佩戴动态血压监测仪24小时，白天每20分钟测量一次血压，夜间在自行选择的8小时卧床时间内每30分钟测量一次。我们比较了使用夜间前半段、后半段的前四次测量值以及两者结合时的夜间血压平均值和血压下降百分比。
夜间收缩压在前半段、后半段和组合测量时存在显著差异（分别为111±9 vs.107±11 vs. 109±9 mmHg，p<0.01），所有类别之间均存在显著的两两差异（每组p<0.01）。收缩压下降百分比在前半段、后半段和组合测量时也存在显著差异（分别为9.9±5.5 vs.13.5±6.4 vs. 11.7±5.0 %，p<0.01），所有类别之间均存在显著的两两差异（每组p<0.01）。舒张压和舒张压下降百分比在三种不同分组中相似。
在中年成年人中，夜间收缩压和血压下降百分比可能取决于夜间测量血压的时间。
