Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi.
Genki Plaza Medical Center for Healthcare, Tokyo, Japan.
J Hypertens. 2024 Dec 1;42(12):2164-2172. doi: 10.1097/HJH.0000000000003862. Epub 2024 Aug 30.
Ambulatory blood pressure (BP) is influenced by physical activity and the BP response to physical activity (actisensitivity) differs between individuals. This study investigated associations between daytime actisensitivity and nighttime BP dipping status and morning BP surge.
Twenty-four-hour ambulatory BP monitoring (ABPM) with simultaneously monitored physical activity using a multisensor all-in-one device (TM-2441; A&D Company) was performed at baseline in HI-JAMP study participants. Those with complete BP measurements and complete physical activity monitoring data were included in this analysis. Actisensitivity was calculated as the slope of the regression line between daytime SBP and log-transformed physical activity over a 5 min period before each BP reading. Hyper and negative reactivity were defined as actisensitivity greater than 90th and less than 10th percentile, respectively.
Data from 2692 individuals (mean age 69.9 ± 11.9 years; mean BMI 24.8 ± 4.1 kg/m 2 , 53.6% men) were analyzed. Those with hyper reactivity had a high prevalence of the extreme dipper pattern of nighttime BP and exaggerated morning BP surge; those with negative reactivity had higher nighttime BP and a riser pattern of nighttime BP. Results remained significant after adjusting for 24-h physical activity. Differences in diurnal BP variability based on actisensitivity were augmented in individuals aged at least 75 years.
This study is the first to investigate associations between actisensitivity and 24-h ambulatory BP profiles using an all-in-one multisensor device in a large real-world population. The associations seen between either hyper or negative actisensitivity and abnormal diurnal BP variability, especially in the elderly, could contribute to increased cardiovascular event risk.
University Hospital Medical Information Network Clinical Trials Registry, UMIN000029151 (HI-JAMP study).
动态血压（BP）受身体活动的影响，且个体之间对身体活动的血压反应（actisensitivity）存在差异。本研究旨在探讨日间 actisensitivity 与夜间 BP 下降状态和清晨 BP 激增之间的关系。
在 HI-JAMP 研究参与者中，使用多传感器一体式设备（TM-2441；A&D 公司）进行 24 小时动态血压监测（ABPM），同时监测身体活动。在该分析中，纳入了具有完整 BP 测量和完整身体活动监测数据的参与者。actisensitivity 通过在每次 BP 读数前 5 分钟内日间 SBP 与对数转换身体活动之间的回归线斜率来计算。高反应性和低反应性分别定义为 actisensitivity 大于第 90 百分位数和小于第 10 百分位数。
共分析了 2692 名参与者的数据（平均年龄 69.9±11.9 岁；平均 BMI 24.8±4.1kg/m 2 ，53.6%为男性）。高反应性者夜间 BP 的极端杓型模式和清晨 BP 激增发生率较高；低反应性者夜间 BP 较高，夜间 BP 呈上升型。调整 24 小时体力活动后，结果仍然具有统计学意义。在年龄至少 75 岁的个体中，基于 actisensitivity 的日间 BP 变异性差异更大。
本研究首次使用一体式多传感器设备在大型真实人群中调查 actisensitivity 与 24 小时动态血压谱之间的关系。高反应性或低反应性与异常昼夜 BP 变异性之间的关联，尤其是在老年人中，可能会增加心血管事件风险。
日本大学医院医疗信息网络临床试验注册，UMIN000029151（HI-JAMP 研究）。
