Diurnal blood pressure variation and cardiovascular prognosis in a community-based study of Ohasama, Japan

Abstract

The introduction of 24-h ambulatory blood pressure (BP) monitoring has enabled BP evaluations at specific times of the day. Associations between diurnal BP variation and cardiovascular prognosis have been investigated in the Ohasama study, which is an epidemiological survey of hypertension using ambulatory and home BP monitoring that has been ongoing since 1985 in the general population of Ohasama, a town located in northern Japan. A diminished nocturnal decline in systolic BP was associated with a greater common carotid intima-media thickness as well as a higher risk of cardiovascular morbidity and mortality, especially the risk for cerebral infarction. The consumption of large amounts of alcohol was associated with a higher morning pressor surge. A large nocturnal decline in BP and a large morning pressor surge were both associated with a risk of cerebral hemorrhage. Ambulatory BP monitoring provides not only static, but also dynamic information about BP that should be considered to ensure effective management of hypertension and cardiovascular diseases.

Fibromyalgia and Nondipper Circadian Blood Pressure Variability

“…The clinical outcomes such as left ventricular hypertrophy, coronary artery diseases, and renal damage are more prevalent in nondipper hypertensive subjects compared with those having normal circadian profile. 9,10,[31][32][33] Of particular interest, nondipper pattern was reported to be associated with higher target organ damage even in normotensive subjects. 34 Regarding the prevention of complications, the treatment strategies based on ambulatory BP measurements have been found superior to the ones based on traditional office BP measurements.…”

Can Acupuncture Affect the Circadian Rhythm of Blood Pressure? A Randomized, Double-Blind, Controlled Trial

“…4 A significant association between cerebrovascular events and the absence of a nocturnal dip has also been reported. [3][4][5][6] Thus, the antihypertensive agents that have been shown to affect nocturnal BP dipping have recently started to be emphasized. There are many studies about the nocturnal dipping effects of antihypertensives such as amlodipine, verapamil, doxazocin, nilvadipine, and barnidipine.…”

“…These results are of interest because there is increasing evidence that nocturnal dipping may be an important predictor of both target-organ damage and cardiovascular events, independent of 24-hour average BP level. [3][4][5][6]21 Circadian rhythm of BP refers to the diurnal variation in BP, which is generally higher during the day than at night. Most people experience a decline in arterial BP in the range of 10%-20% during the night.…”

“…[3][4][5] In the Ohasama Study, the risk for cerebral infarction was significantly higher among individuals with nondipping; the relative hazard was 1.6 (95% confidence interval, 1.0-2.5, p = 0.04). 6 There was also a linear relationship between the nocturnal BP dipping and cardiovascular mortality. On average, each 5% decrease in nocturnal BP dipping was associated with an approximately 20% greater risk of cardiovascular mortality.…”

Ambulatory BP monitoring and clinic BP in predicting small-for-gestational-age infants during pregnancy

“…The results of this study support the clinical significance of ABPM for the management of hypertension during pregnancy. 25 Although there have been some articles about ABP in non-pregnant human subjects, 14,26,27 this is one of the largest studies to show a clear association between high ABP and SGA in pregnant women with hypertensive disorders during pregnancy. Peek et al 25 showed that automated DBP were significantly associated with low birth weight below the tenth percentile.…”