AMBULATORY BLOOD AMBULATORY BLOOD PRESSURE MONITORING PRESSURE MONITORING

HEALTH WATCH IN BRNO, HEALTH WATCH IN BRNO, CZECH REPUBLICCZECH REPUBLIC

Homolka P., Siegelová J., Cornélissen G.*, Homolka P., Siegelová J., Cornélissen G.*,

Fišer B., Dušek J., Vank P., Mašek M., Halberg F.*Fišer B., Dušek J., Vank P., Mašek M., Halberg F.*Masaryk University, Brno, Czech Republic, Masaryk University, Brno, Czech Republic,

*University of Minnesota, Minneapolis, MN, USA *University of Minnesota, Minneapolis, MN, USA

BackgroundBackground

About-weekly, half-weekly and/or circadian About-weekly, half-weekly and/or circadian componentscharacterize systolic (S) and componentscharacterize systolic (S) and diastolic (D) BP, the circaseptan- to-circadian diastolic (D) BP, the circaseptan- to-circadian prominence tending to be larger in MESOR-prominence tending to be larger in MESOR-(chronome [time structure]-derived average)  (chronome [time structure]-derived average)  hypertension.hypertension.

AimAim

To assess the chronome of 7-day/24-hour blood pressure (BP) and To assess the chronome of 7-day/24-hour blood pressure (BP) and heart rate (HR).heart rate (HR).

Subjects and methodsSubjects and methods

BP and HR profiles at 30-min intervals from 179 BP and HR profiles at 30-min intervals from 179 subjects were analyzed by sphygmochron.subjects were analyzed by sphygmochron.

Fig. 1Fig. 1

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CHATCHAT

BP overswinging „Circadian Hyper-Amplitude-BP overswinging „Circadian Hyper-Amplitude-Tension“ (CHAT), a vascular disease risk factorTension“ (CHAT), a vascular disease risk factor

was detected in 8.5% and 7.0% (SBP/DBP). was detected in 8.5% and 7.0% (SBP/DBP). CHAT was associated with evening exercise in CHAT was associated with evening exercise in one subject. one subject.

HRVHRV

Decreased heart rate variability occurred in Decreased heart rate variability occurred in 2.2 %. Decreased heart rate variability is 2.2 %. Decreased heart rate variability is accomplist with increased sympathetic accomplist with increased sympathetic activity and increased cardiovascular risk.activity and increased cardiovascular risk.

MESORMESOR

In data from the first 179 profiles (49 F, 130M, In data from the first 179 profiles (49 F, 130M, 20-77 years of age), women had a lower SBP-20-77 years of age), women had a lower SBP-MESORMESOR(P=0.026) and a higher HR-MESOR (P=0.005) (P=0.026) and a higher HR-MESOR (P=0.005) than men. SBP increased linearly with age than men. SBP increased linearly with age (r=0.341, P<0.001). The MESORs of DBP and (r=0.341, P<0.001). The MESORs of DBP and HR and the circadian amplitudes of SBP and HR and the circadian amplitudes of SBP and DBP followed a quadratic model, reaching DBP followed a quadratic model, reaching maxima values around 40-60 years of age. maxima values around 40-60 years of age.

The 7-day and 3.5-day amplitudes of BP and HR The 7-day and 3.5-day amplitudes of BP and HR were correlated (P<0.001), as were the 3.5-day were correlated (P<0.001), as were the 3.5-day and circadian amplitudes of SBP (P=0.004) and and circadian amplitudes of SBP (P=0.004) and HR (P=0.013). The 7-day and circadian HR (P=0.013). The 7-day and circadian amplitudes of SBP (P=0.067) and DBP amplitudes of SBP (P=0.067) and DBP (P=0.046) were weakly associated.(P=0.046) were weakly associated.Circaseptan component is statistically significant Circaseptan component is statistically significant for blood pressure but not for heart rate. The for blood pressure but not for heart rate. The half-week is significant for all 3 variables, as is half-week is significant for all 3 variables, as is the circadian rhythm. The acrophases are around the circadian rhythm. The acrophases are around mid-week and mid-afternoon for the week and mid-week and mid-afternoon for the week and day, respectively.day, respectively.

RHYTHMRHYTHM

CONCLUSIONCONCLUSION

Gender differences and changes with age are keeping Gender differences and changes with age are keeping with earlier independent investigations. CHAT was with earlier independent investigations. CHAT was detected in 8.5% and 7.0 % (SBP/DBP). Decreased detected in 8.5% and 7.0 % (SBP/DBP). Decreased heart rate variability occurred in 2.2 %.heart rate variability occurred in 2.2 %.

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