Key result
Applying various definitions of dipping and daytime/night-time to 894 ambulatory blood pressure recordings resulted in significant variations in the classification of dipper status.
Why the study?
Do different definitions of dipping and daytime/night-time lead to different classifications of dipper status in 24-hour ambulatory blood pressure monitoring?
Observational (n=894)
No
Do different definitions of dipping and daytime/night-time lead to different classifications of dipper status in 24-hour ambulatory blood pressure monitoring?
The choice of definition for daytime, night-time, and dipping significantly alters the classification of patients' 24-hour blood pressure profiles, which is critical for interpreting and designing clinical studies.
Answers are grounded in this paper and cite their sources.
Definition-dependent dipper classification varies in ABPM; leaves open standardization needs for consistent research and cautious clinical interpretation.
BACKGROUND: Ambulatory blood pressure monitoring allows characterization of the patient's average blood pressure load as well as various profiles of blood pressure. Results from clinical studies suggest that dippers (patients whose blood pressures decrease during night-time) have a lower risk of cardiovascular events than do nondippers with similar daytime blood pressures. However, the definitions of dipping as well as of daytime and night-time vary among clinical studies. OBJECTIVE: To determine whether various definitions lead to markedly different classifications of dipper status. DESIGN AND METHODS: We analyzed 894 24 h ambulatory blood pressure recordings that had been performed at our institution according to three previously published definitions of daytime and night-time and five definitions of dipping. RESULTS: There were small but statistically significant differences among the mean daytime and night-time blood pressures determined using the various definitions. Likewise, the proportions of dippers varied significantly with definitions of dipping and of daytime and night-time. CONCLUSIONS: Differences among definitions of dipping as well as of daytime and night-time lead to significant variations in the characterization of patients' 24 h blood blood pressure profiles. The results of this analysis can be used when comparing the results of clinical studies as well as in their design.
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Butkevich et al. (2000) conducted an observational in Blood pressure profiles (n=894). Definitions of dipping and daytime/night-time vs. Alternative definitions was evaluated on Classification of dipper status and mean daytime/night-time blood pressures. Applying various definitions of dipping and daytime/night-time to 894 ambulatory blood pressure recordings resulted in significant variations in the classification of dipper status.
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