Measurements of base blood pressure during sleep and its clinical significance in hypertensive patients.

Tochikubo, Osamu; Ochiai, Hisao; Oota, Takashi; Miyajima, Eiji; Kaneko, Yoshihiro

doi:10.1253/jcj.51.1174

Cited by 22 publications

(18 citation statements)

References 12 publications

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“…NABP monitoring has been shown to have some problems as compared with intra-arterial BP recording. For instance, the extent of the nocturnal fall in blood pressure has been small, perhaps maybe due to an interference with sleep (14). However, in our study, the nocturnal fall was 24.6 mmHg in normotensive elderly patients; the HR also fell significantly at night and there was no apparent interference with sleep.…”

Section: Resultscontrasting

confidence: 66%

Nocturnal Blood Pressure Monitored by Ambulatory Blood Pressure Measurement in Elderly Hypertensive Patients.

et al. 1992

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This study was designed to characterize the nocturnal fall of blood pressure (NFBP) of elderly hypertensive patients (EH), with or without cerebrovascular disease or diabetes mellitus, as measured by automated blood pressure (BP) monitoring. Systolic and diastolic BP and heart rate was measured every 15 minutes in 133 hospitalized patients with nearly similar schedules and diets. The patients were divided into five groups: I, normotensive elderly patients over age 65: II, EH without cardiovascular diseases, controlled without medication: III, EH with cerebral infarction, chronic stage: IV, EH with noninsulin-dependent diabetes mellitus: and V, hypertensives under age 65, without cardiovascular diseases. A significant NFBP was observed in the patients of groups I and V, a significant but smaller NFBP in the hypertensives of groups II and IV, and no NFBP in the patients of group III. Administration of the antihypertensive drugs, enalapril and nifedipine, tended to augment the NFBP. These preliminary observations showed that NFBP did occur in elderly hypertensives but the fall was smaller than that observed in younger hypertensives or elderly normotensives. Although the ambulatory BP measurements were useful in the overall clinical evaluation of elderly patients, NFBP in elderly patients was affected by hypertensive drugs and therefore NFBP should be interpreted with caution. (Internal Medicine 31: 441-446, 1992)

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Section: Resultscontrasting

confidence: 66%

Nocturnal Blood Pressure Monitored by Ambulatory Blood Pressure Measurement in Elderly Hypertensive Patients.

et al. 1992

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“…In our detailed analysis of 24-h BP (26,27), we have shown that, whereas daytime BP changes markedly according to physical and mental activity, minimum sleep BP (base BP) is stable (10,26). We have reported that this BP could be the true basal BP that Smirk et al (28) had advocated.…”

Section: Fig 4 Nonlinear Relation Between Sleep Sbp and 24-h Urinarmentioning

confidence: 83%

“…We have reported that this BP could be the true basal BP that Smirk et al (28) had advocated. Because base BP is measured during deep sleep, at a time when the heart rate is low and stable, it is little affected by daytime activity (10,26,27,29). In addition to sodium intake, daytime BP is affected by a large number of other factors, including physical and mental activity.…”

Section: Fig 4 Nonlinear Relation Between Sleep Sbp and 24-h Urinarmentioning

confidence: 99%

Relation between Sodium Intake and Blood Pressure during Sleep in Young Men.

Nishijima

Tochikubo

2003

Hypertens Res

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In the past, cross-sectional studies of small groups have not always shown a significant relation between habitual sodium intake and blood pressure (BP). This study examined the relation between 24-h urinary sodium excretion (Salt24, g/day) and BP during sleep in young subjects. The subjects were 132 medical students (93 males, 39 females) aged 21 to 26 years, with no renal disorder. Urine was collected for 24 h, and sodium (Na), chloride (Cl), and creatinine ( and estimated their sodium intake by 24-h urine-sampling for 1 week. On the final urine-sampling day, we measured their BP for 24 h, and then made a detailed analysis of the correlation between 24-h urinary sodium excretion (Salt24) and 24-h BP. Methods SubjectsWe interviewed 142 volunteers who were medical students (99 males and 43 females) and traced their past medical history and family medical history. We excluded subjects with renal or cardiac disease. Subjects with a family history of hypertension (in parents or grandparents) were classified as familial hypertension-positive. Resting mean casual BP by the auscultatory method was as follows: male systolic blood

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“…Our results showed that short-term BPV was greater in the stroke patients and that might be related to dysfunction of baroreflex and autonomic nervous dysfunction. 24 The baroreflex plays a role in buffering moment-to-moment variations of BP. 24,25 In the present study, a greater increase in BP during exercise was observed in the stroke patients with lower LF/HF and LF/HFd-n (especially in those with LF/HFd-n ≤1), and sympathetic nervous function was decreased after stroke with a thalamic lesion.…”

Section: Discussionmentioning

confidence: 99%

“…24 The baroreflex plays a role in buffering moment-to-moment variations of BP. 24,25 In the present study, a greater increase in BP during exercise was observed in the stroke patients with lower LF/HF and LF/HFd-n (especially in those with LF/HFd-n ≤1), and sympathetic nervous function was decreased after stroke with a thalamic lesion. Moreover, stroke patients suffered from many risk factors, such as hypertension, atherosclerosis and aging, which would cause an increase in SBP during exercise and greater diurnal variability of BP.…”

Section: Discussionmentioning

confidence: 99%

Relation Between 24-h Heart Rate Variability and Blood Pressure Fluctuation During Exercise in Stroke Patients

Nishioka

Sashika

Andho

et al. 2005

Circ J

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lood pressure (BP) and heart rate (HR) often fluctuate extensively in stroke patients during the acute to subacute phase. 1 In addition, cerebral blood flow is dependent on systemic BP during these phases because of the disturbance of autoregulation of cerebral blood flow. 2 Therefore it is important to consider the risk of stroke relapse or progression caused by fluctuating BP, such as an increase or decrease of BP and BP variability (BPV). 3,4 Some clinical studies have shown that an abnormal pattern of variability of diurnal BP, evaluated by 24-h ambulatory BP monitoring, 5 is associated with target organ damage. 6 Currently, the Holter ECG is used to monitor spontaneous heart rate variability (HRV) to assess the function of the cardiac autonomic nervous system in stroke patients. [7][8][9][10][11] Singh et al reported that autonomic nervous system activity, monitored by HRV, was related to 24-h BPV. 12 Clinical and experimental studies have examined how the localization of stroke affects autonomic function and prognosis. [13][14][15] Stroke patients with a lesion in the thalamus or brain stem often show high BP and other cardiovascular dysfunction. We assumed that stroke patients with a thalamic lesion would exhibit autonomic nervous dysfunction.The purpose of this study was to clarify the autonomic nervous system dysfunction and evaluate the risk during medical rehabilitation in stroke patients with a thalamic Circulation Journal Vol.69, June 2005 lesion, using 24-h HRV and 24-h BPV. The relationship between HRV, as well as 24-h BPV, and the change in BP during exercise was also investigated. Methods SubjectsThe subjects were patients who were admitted to the Stroke Medical Center within 2 weeks of the onset of their first stroke. The stroke group (Table 1) Relation Between 24-h Heart Rate Variability and Blood Pressure Fluctuation During Exercise in Stroke PatientsYasuko Nishioka, MD; Hironobu Sashika, MD*; Norihiko Andho, MD*; Osamu Tochikubo, MD** Background In some stroke patients blood pressure (BP) fluctuates extensively during medical rehabilitation, so the present study investigated the influence of autonomic nervous dysfunction on the change in BP during exercise. Methods and ResultsThe subjects consisted of 55 stroke inpatients (males, 29; mean age, 58.8 years old; ischemic/hemorrhagic etiology, 30/25) who were admitted to the Stroke Center within 2 weeks of their first stroke. The control group consisted of 15 age-matched healthy volunteers. The 24-h heart rate (HR) variability (HRV) and BP variability (BPV) were examined, and then the increase and recovery of BP and HR were measured during bicycle ergometer exercise at 4 METs. Components of 24-h HRV (low-frequency power (LF), highfrequency power (HF), LF/HF, and asleep -awake ratio of LF/HF (LF/HFd-n)) were lower (p<0.01) and BPV was greater in the stroke group (p<0.05) than in the control group. There was a negative correlation between BP change during exercise and LF/HF or LF/HFd-n (r=-0.43 or r=-0.58, p<0.01), and a greater increase in sy...

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Measurements of base blood pressure during sleep and its clinical significance in hypertensive patients.

Cited by 22 publications

References 12 publications

Nocturnal Blood Pressure Monitored by Ambulatory Blood Pressure Measurement in Elderly Hypertensive Patients.

Nocturnal Blood Pressure Monitored by Ambulatory Blood Pressure Measurement in Elderly Hypertensive Patients.

Relation between Sodium Intake and Blood Pressure during Sleep in Young Men.

Relation Between 24-h Heart Rate Variability and Blood Pressure Fluctuation During Exercise in Stroke Patients

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