Zhu Jia-Bo, Guo Qian-Hui, Zhou Yi, Wang Wen-Yuan-Yue, Kang Yuan-Yuan, Ye Xiao-Fei, Wang Xin-Yu, Li Ming-Xuan, Li Yan, Wang Ji-Guang
Department of Cardiovascular Medicine, Centre for Epidemiological Studies and Clinical Trials, Shanghai Key Laboratory of Hypertension, The Shanghai Institute of Hypertension, National Research Centre for Translational Medicine at Shanghai, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Am J Hypertens. 2025 Jul 20. doi: 10.1093/ajh/hpaf137.
We investigated the morning-to-evening changes in home blood pressure (BP) and pulse rate for demographic and clinical determinants, interrelationship and association with BP control in treated patients with hypertension.
We performed cross-sectional analysis in patients (≥55 years of age) with hypertension, enrolled in a China nationwide registry on home BP monitoring between 2020 and 2025. Home BP was measured three times consecutively in the morning and evening, respectively, for seven consecutive days. The change was calculated by subtracting the BP and pulse rate values in the morning from that in the evening.
The 4787 participants had a mean (±SD) age of 66.1 (±7.5) years, and included 2366 (49.4%) men. Overall, systolic/diastolic BP decreased from 129.1/80.6 mmHg in the morning to 127.2/78.7 mmHg in the evening by a mean change of -1.9±7.8/-1.8±4.7 mmHg. Pulse rate, however, increased from 70.5 beats/min in the morning to 73.7 beats/min in the evening by a mean change of +3.1±5.8 beats/min. Adjusted analyses showed that the changes in pulse rate were negatively associated with that in both systolic (r=-0.20, 95% CI: -0.22 to -0.17) and diastolic BP (r=-0.12, 95%CI: -0.14 to -0.09). Patients with a change in pulse rate above the median (≥3.0 beats/min) had a lower control rate of office systolic/diastolic BP (60.1% vs. 65.5%, P<0.001) than those with a change in pulse rate below the median.
There were interrelated morning-to-evening changes in home BP and pulse rate, being a drop and rise, respectively.
我们研究了接受治疗的高血压患者家庭血压（BP）和脉搏率从早晨到晚上的变化情况，以及人口统计学和临床决定因素、相互关系及其与血压控制的关联。
我们对年龄≥55岁的高血压患者进行了横断面分析，这些患者入选了2020年至2025年在中国全国范围内开展的家庭血压监测登记研究。连续7天，分别在早晨和晚上连续测量3次家庭血压。变化值通过晚上的血压和脉搏率值减去早晨的相应值来计算。
4787名参与者的平均（±标准差）年龄为66.1（±7.5）岁，其中男性2366名（49.4%）。总体而言，收缩压/舒张压从早晨的129.1/80.6 mmHg降至晚上的127.2/78.7 mmHg，平均变化为-1.9±7.8/-1.8±4.7 mmHg。然而，脉搏率从早晨的70.5次/分钟增加到晚上的73.7次/分钟，平均变化为+3.1±5.8次/分钟。校正分析显示，脉搏率变化与收缩压（r=-0.20，95%CI：-0.22至-0.17）和舒张压（r=-0.12，95%CI：-0.14至-0.09）变化均呈负相关。脉搏率变化高于中位数（≥3.0次/分钟）的患者诊室收缩压/舒张压控制率（60.1%对65.5%，P<0.001）低于脉搏率变化低于中位数的患者。
家庭血压和脉搏率从早晨到晚上存在相互关联的变化，分别是下降和上升。
