Key result
The nocturnal fall in systolic blood pressure was smaller centrally (-6.0 mm Hg) than peripherally (-10.4 mm Hg) (P<0.001).
Observational (n=167)
No
p-value: p=<0.001
The diurnal rhythm of central blood pressure parallels peripheral pressure, but the nocturnal fall in systolic blood pressure is smaller centrally than peripherally.
Peripheral measures may overestimate nocturnal dipping; leaves open whether central BP improves risk stratification.
BACKGROUND: No previous population study assessed the diurnal profile of central arterial properties. METHODS: In 167 participants (mean age, 56.1 years; 63.5% women), randomly recruited in Montevideo, Uruguay, we used the oscillometric Mobil-O-Graph 24-h PWA monitor to measure peripheral and central systolic (SBP), diastolic (DBP), and pulse (PP) pressures and central hemodynamics standardized to a heart rate of 75 bpm, including aortic pulse wave velocity, systolic augmentation (first/second peak × 100), and pressure amplification (peripheral PP/central PP). RESULTS: Over 24 hours, day and night, peripheral minus central differences in SBP/DBP and in PP averaged 12.2/-1.1, 14.0/-0.7, and 9.7/0.2mm Hg and 12.6, 14.7, and 9.5mm Hg, respectively (P < 0.001 except for nighttime DBP (P = 0.38)). The central-to-peripheral ratios of SBP, DBP, and PP were 0.89, 1.00, and 0.70 unadjusted, but after accounting for anthropometric characteristics decreased to 0.74, 0.97, and 0.63, respectively, with strong influence of height for SBP and DBP and of sex for PP. From day (10-20h) to nighttime (0-6h), peripheral (-10.4/-10.5 mm Hg) and central (-6.0/-11.3mm Hg) SBP/DBP, pulse wave velocity (-0.7 m/s) and pressure amplification (-0.05) decreased (P < 0.001), whereas central PP (+5.3mm Hg) and systolic augmentation (+2.3%) increased (P < 0.001). CONCLUSIONS: The diurnal rhythm of central pressure runs in parallel with that of peripheral pressure, but the nocturnal fall in SBP is smaller centrally than peripherally. pulse wave velocity, systolic augmentation, and pressure amplification loop through the day with high pulse wave velocity and pressure amplification but low systolic augmentation in the evening and opposite trends in the morning.
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Boggia et al. (2015) conducted an observational in General population (n=167). Nighttime (0-6h) vs. Daytime (10-20h) was evaluated on Change in central and peripheral systolic blood pressure from day to nighttime (p=<0.001). The nocturnal fall in systolic blood pressure was smaller centrally (-6.0 mm Hg) than peripherally (-10.4 mm Hg) (P<0.001).
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