Analysis of 2196 Systematic Blood Pressure Measurements shows highest BP in the evening – An Exceptional Case or Refutation of Generally Accepted Hypotheses?

An aged male measured his systolic and diastolic blood pressure, left and right, three times a day (morning, afternoon and evening) during a full year under specified conditions and under supervision of both his GP and the authors of the present study. This is the first time that systematic BP measurements of an individual during so many (366) consecutive days have been documented. Analysis of the results indicates that, in contrast to generally accepted views, the highest blood pressure did not occur in the morning (the so-called morning surge) or afternoon (following what is considered to be a circadian cycle for BP), but in the evening. It is also found that the fluctuations in both SBP and DBP are so irregular that momentary values cannot be considered to provide reliable information about the actual blood pressure, and thus about possible cardiovascular risks. Rather, a series of measurements during morning, afternoon and evening should be used. Because this is the first time that such an investigation has been carried out, it can, however, not be fully excluded (though unlikely) that the patient involved represents an exceptional case. Consequently, more comparable studies are needed to confirm or falsify the generic validity of the results found here, which seems of great importance for fighting hypertension and related health risks.