Pilz Niklas, Heinz Viktor, Parati Gianfranco, Haberl Ralph, Hofmann Elisabeth, Küchler Gert, Patzak Andreas, Bothe Tomas L
Institute of Translational Physiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany.
Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany.
J Clin Med. 2024 Apr 9;13(8):2170. doi: 10.3390/jcm13082170.
Nocturnal blood pressure (BP) monitoring is essential for evaluating cardiovascular risk and guiding treatment decisions. However, the standardized narrow-fixed nighttime period between 10 p.m. and 6 a.m. may not accurately reflect individual sleep schedules. This pilot study aimed to investigate the comparability between the standardized nighttime period and actual time in bed (TIB) regarding BP assessment. Further, our goal was to evaluate the clinical relevance of the observed BP differences. A total of 30 participants underwent 24 h ambulatory blood pressure monitoring (ABPM). Patient-specific TIB was precisely assessed through an accelerometer and a position sensor from the SOMNOtouch NIBP™ (SOMNOmedics GmbH, Randersacker, Germany). We analysed the effect of considering individual TIB as nighttime instead of the conventional narrow-fixed interval on the resulting nocturnal BP levels and dipping patterns. : We observed differences in both systolic and diastolic BP between the standardized nighttime period and the TIB. Furthermore, a notable percentage of patients (27%) changed their dipping pattern classification as a function of the nighttime definition adopted. We found strong correlations between the start (r = 0.75, < 0.01), as well as the duration (r = -0.42, = 0.02) of TIB and the changes in dipping pattern classification. : Definition of nocturnal period based on the individual TIB leads to clinically relevant changes of nocturnal BP and dipping pattern classifications. TIB is easily detected using a body position sensor and accelerometer. This approach may thus improve the accuracy of cardiovascular risk evaluation and enhance treatment strategies.
夜间血压监测对于评估心血管风险和指导治疗决策至关重要。然而，晚上10点至早上6点这一标准化的固定狭窄夜间时段可能无法准确反映个体的睡眠时间表。这项初步研究旨在调查标准化夜间时段与实际卧床时间（TIB）在血压评估方面的可比性。此外，我们的目标是评估观察到的血压差异的临床相关性。共有30名参与者接受了24小时动态血压监测（ABPM）。通过来自SOMNOtouch NIBP™（德国兰德斯萨克的SOMNOmedics GmbH公司）的加速度计和位置传感器精确评估患者特定的TIB。我们分析了将个体TIB视为夜间时段而非传统固定狭窄间隔对夜间血压水平和血压下降模式的影响。我们观察到标准化夜间时段与TIB之间收缩压和舒张压均存在差异。此外，相当比例的患者（27%）根据所采用的夜间定义改变了他们血压下降模式的分类。我们发现TIB的开始时间（r = 0.75，P < 0.01）以及持续时间（r = -0.42，P = 0.02）与血压下降模式分类的变化之间存在强相关性。基于个体TIB定义夜间时段会导致夜间血压和血压下降模式分类出现具有临床意义的变化。使用体位传感器和加速度计可轻松检测TIB。因此，这种方法可能会提高心血管风险评估的准确性并优化治疗策略。
