Key result
Sleep-time hypertension was associated with reduced 24-hour and 12-hour blood pressure rhythm amplitude and integrity, and significantly higher 24-hour acrophase variability.
Why the study?
Does sleep-time hypertension alter circadian and ultradian blood pressure rhythms?
Observational (n=378)
Does sleep-time hypertension alter circadian and ultradian blood pressure rhythms?
Sleep-time hypertension is associated with blunted circadian blood pressure rhythms and increased acrophase variability, suggesting a disorganization that may contribute to cardiovascular risk.
Answers are grounded in this paper and cite their sources.
May indicate higher CV risk via rhythm disruption in sleep-time hypertension; leaves open causal role and need for prospective trials.
24 h and ultradian rhythms of blood pressure (BP) have been previously shown to be disorganized in nocturnal hypertensive subjects. The present study was undertaken to further analyze the ultradian and circadian BP rhythm structure in sleep-time hypertensive subjects with normal or elevated awake-time BP levels. Fourier analysis was used to fit 24, 12, 8, and 6 h curves to mean BP as well as heart rate (HR) time series data derived from 24 h ambulatory blood pressure monitoring. Awake and sleep periods were defined according to individual sleep diaries. Awake-time hypertension was defined as diurnal systolic (SBP) and/or diastolic BP (DBP) means > or =135/85 mmHg. Sleep-time hypertension was defined as nocturnal SBP and/or DBP means > or =120/70 mmHg. The sample included 240 awake-time normotensive subjects (180 sleep-time normotensives and 60 sleep-time hypertensives) and 138 untreated awake-time hypertensive subjects (31 sleep-time normotensives and 107 sleep-time hypertensives). The amplitude and integrity (i.e., percent rhythm) of the 24 and 12 h BP rhythms were lower in the sleep-time hypertensive subjects and higher in the awake-time hypertensive subjects. However, no differences were detected when the integrity and amplitude of the 6 and 8 h mean BP rhythms were analyzed. The sleep-time hypertensive group showed significantly higher 24 h BP rhythm acrophase variability. No differences could be found in any of the HR rhythm parameters. Altogether, the findings suggest a disorganization of the BP circadian rhythm in sleep-time hypertensives that results in reduced 24 h rhythm amplitude and integrity that could be related to cardiovascular risk.
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Perez‐Lloret et al. (2008) conducted an observational in Hypertension (n=378). Sleep-time hypertension vs. Sleep-time normotension was evaluated on Amplitude, integrity, and acrophase variability of 24-hour and 12-hour blood pressure rhythms. Sleep-time hypertension was associated with reduced 24-hour and 12-hour blood pressure rhythm amplitude and integrity, and significantly higher 24-hour acrophase variability.
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