Ambulatory blood pressure monitoring: Assessing the diurnal variation of blood pressure

Abstract

The purposes of this paper are to examine the effects of activity, situation of measurement, mood, and occupation on the daily variation of blood pressure and to discuss the potential utility of ambulatory blood pressure monitoring in physical anthropological studies. The subjects of the blood pressure variability study are 125 men who were referred to the Hypertension Center at New York Hospital--Cornell Medical Center for evaluation of hypertension. There were 1,386 blood pressure measurements from these subjects available for study, which were taken using noninvasive ambulatory blood pressure monitoring techniques. Pressures were transformed to z scores using the subject's daily mean pressure and standard deviation to assess the relative elevation during the experience of the various factors. The results show that activity and mood are the most significant sources of blood pressure variation (P less than .005) and are additive. Occupation, which may be an indicator of social class in this population, also modified the mood effects. Because ambulatory blood pressure monitors obtain many readings over a day under a variety of circumstances, their use can improve epidemiological and human biological studies of the inheritance and variability of blood pressure. Ambulatory blood pressure monitoring is an important new tool in the study of human biological variation.

Renin, ANP, ACE polymorphisms, blood pressure and age in American Samoans: Preliminary data

“…Blood pressure is a variable phenotype that shows both intraindividual variation and, within any one individual, diurnal variation (James and Baker, 1990;James and Pickering, 1991). For this sample all blood pressure measurements were completed between 4 and 9 p.m. after normal working hours.…”

Renin, ANP, ACE polymorphisms, blood pressure and age in American Samoans: Preliminary data

“…Blood pressure is a variable phenotype that shows both intraindividual variation and, within any one individual, diurnal variation (James and Baker, 1990;James and Pickering, 1991). For this sample all blood pressure measurements were completed between 4 and 9 p.m. after normal working hours.…”

A Comparative Analysis of Arterial Oxygen Saturation among Tibetans And Han Born And Raised at High Altitude

“…Finally, a variety of different protocols has been used to convert the continuous LCD readout produced by pulse oximeters to a single arterial oxygen saturation value for each individual. While the consequences of this source of error have not been assessed, future studies might benefit from the use of instruments that can produce a 24-h continuous recording of Sp O 2 values, similar to the recordings made using 24-h blood pressure monitors (James and Pickering, 1991). Using this technology, which is now available, would provide a standardized protocol for determining measures of central tendency (or the basis of a cumulative frequency analysis) and also might be important for understanding diurnal variations in saturation (sleep vs. awake) and for assessing the effects of different activity levels.…”

Striking a chord: Moods, blood pressure, and heart rate in everyday life

“…Since then, ambulatory studies continue to document the significance of moods for BP, although the magnitude of the effects for particular moods and the direction of differences in BP between different kinds of moods vary from study to study, and the effects also vary as a function of health status and ethnicity (Brown, James, & Nordloh, 1998;Gellman et al, 1990;James, Yee, Harshfield, Blank, & Pickering, 1986;Southard, Eisler, & Skidmore, 1988). In a study of 125 men who were patients referred to a hypertension center (James & Pickering, 1991), mood ratings contributed a significant source of variation to BP; the study used 10-point mood scales, but no specific findings are given on the relation between mood intensity and BP. In a mixed sample of hypertensive and normotensive subjects, positive and negative mood were associated with higher BP, but reports of feeling tired (presence or absence) were related to a decrease in BP (Schwartz, Warren, & Pickering, 1994).…”

Renin, ANP, ACE polymorphisms, blood pressure and age in American Samoans: Preliminary data

“…Blood pressure is a variable phenotype that shows both intraindividual variation and, within any one individual, diurnal variation (James and Baker, 1990;James and Pickering, 1991). For this sample all blood pressure measurements were completed between 4 and 9 p.m. after normal working hours.…”

A Comparative Analysis of Arterial Oxygen Saturation among Tibetans And Han Born And Raised at High Altitude

“…Finally, a variety of different protocols has been used to convert the continuous LCD readout produced by pulse oximeters to a single arterial oxygen saturation value for each individual. While the consequences of this source of error have not been assessed, future studies might benefit from the use of instruments that can produce a 24-h continuous recording of Sp O 2 values, similar to the recordings made using 24-h blood pressure monitors (James and Pickering, 1991). Using this technology, which is now available, would provide a standardized protocol for determining measures of central tendency (or the basis of a cumulative frequency analysis) and also might be important for understanding diurnal variations in saturation (sleep vs. awake) and for assessing the effects of different activity levels.…”

Striking a chord: Moods, blood pressure, and heart rate in everyday life

“…Since then, ambulatory studies continue to document the significance of moods for BP, although the magnitude of the effects for particular moods and the direction of differences in BP between different kinds of moods vary from study to study, and the effects also vary as a function of health status and ethnicity (Brown, James, & Nordloh, 1998;Gellman et al, 1990;James, Yee, Harshfield, Blank, & Pickering, 1986;Southard, Eisler, & Skidmore, 1988). In a study of 125 men who were patients referred to a hypertension center (James & Pickering, 1991), mood ratings contributed a significant source of variation to BP; the study used 10-point mood scales, but no specific findings are given on the relation between mood intensity and BP. In a mixed sample of hypertensive and normotensive subjects, positive and negative mood were associated with higher BP, but reports of feeling tired (presence or absence) were related to a decrease in BP (Schwartz, Warren, & Pickering, 1994).…”

Renin, ANP, ACE polymorphisms, blood pressure and age in American Samoans: Preliminary data

“…Blood pressure is a variable phenotype that shows both intraindividual variation and, within any one individual, diurnal variation (James and Baker, 1990;James and Pickering, 1991). For this sample all blood pressure measurements were completed between 4 and 9 p.m. after normal working hours.…”

A Comparative Analysis of Arterial Oxygen Saturation among Tibetans And Han Born And Raised at High Altitude

“…Finally, a variety of different protocols has been used to convert the continuous LCD readout produced by pulse oximeters to a single arterial oxygen saturation value for each individual. While the consequences of this source of error have not been assessed, future studies might benefit from the use of instruments that can produce a 24-h continuous recording of Sp O 2 values, similar to the recordings made using 24-h blood pressure monitors (James and Pickering, 1991). Using this technology, which is now available, would provide a standardized protocol for determining measures of central tendency (or the basis of a cumulative frequency analysis) and also might be important for understanding diurnal variations in saturation (sleep vs. awake) and for assessing the effects of different activity levels.…”

Striking a chord: Moods, blood pressure, and heart rate in everyday life

“…Since then, ambulatory studies continue to document the significance of moods for BP, although the magnitude of the effects for particular moods and the direction of differences in BP between different kinds of moods vary from study to study, and the effects also vary as a function of health status and ethnicity (Brown, James, & Nordloh, 1998;Gellman et al, 1990;James, Yee, Harshfield, Blank, & Pickering, 1986;Southard, Eisler, & Skidmore, 1988). In a study of 125 men who were patients referred to a hypertension center (James & Pickering, 1991), mood ratings contributed a significant source of variation to BP; the study used 10-point mood scales, but no specific findings are given on the relation between mood intensity and BP. In a mixed sample of hypertensive and normotensive subjects, positive and negative mood were associated with higher BP, but reports of feeling tired (presence or absence) were related to a decrease in BP (Schwartz, Warren, & Pickering, 1994).…”