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Differences in Circadian Rhythms of Blood Pressure and Heart Rate Among Hypertensive and Normal Blood Pressure Subjects

  • Silveri GiuliaEmail author
  • Pascazio Lorenzo
  • Sabbadini Gastone
  • Guerra Monica
  • Accardo Agostino
Conference paper
Part of the IFMBE Proceedings book series (IFMBE, volume 76)

Abstract

The purpose of this study was to evaluate the differences in the circadian variations of blood pressure (BP) and heart rate (HR) among three subject groups (hypertensive, normal/high normal and optimal blood pressure). The ambulatory BP and HR of 385 subjects, without clinical evidence of hypertension-related complications, were acquired using a Holter Blood Pressure Monitor and their circadian patterns were analyzed. Systolic, Diastolic and Mean BP showed four different well-defined trends in specific time intervals of the day, similar for the three BP measures and among the three subject groups. Both BP and HR signals presented a decrease between 10:00 and 14:30 and from 19:00 to 2:00 and an increase from 5:00 to 10:00. Between 14:30 and 19:00, BP and HR presented an opposite relationship with decreasing HR and increasing BP, not yet reported in the literature. The behaviors of BP and HR were well approximated in each of the four periods by linear trends in all the three subject groups. On the contrary, in the period between 2:00 and 5:00 both BP and HR showed a quite constant trend. Results support the hypothesis of an independent vagal control during 24-h in respect of HR and BP mean levels, the latter depending on the specific subject group. Moreover, linear approximation in the identified four intervals could be used to quantify the circadian changes for all kind of subjects.

Keywords

Heart rate Blood pressure Monitoring and control systems 

Notes

Acknowledgements

Work partially supported by the Master in Clinical Engineering, University of Trieste.

Conflict of Interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Lawes, C.M., Vander Hoorn, S., Rodgers, A.: 2008 global burden of blood-pressure-related disease 2001. Lancet 371, 1513–1518 (2008)CrossRefGoogle Scholar
  2. 2.
    Zanchetti, A., Thomopoulos, C., Parati, G.: Randomized controlled trials of blood pressure lowering in hypertension: a critical reappraisal. Circ. Res. 116, 1058–1073 (2015)CrossRefGoogle Scholar
  3. 3.
    Palatini, P., Benetos, A., Grassi, G., Julius, S.: Identification and management of the hypertensive patient with elevated heart rate: statement of a European society of hypertension consensus meeting. J. Hypertens. 24, 603–610 (2006)CrossRefGoogle Scholar
  4. 4.
    Kannel, W.B., Kannel, C., Paffenbarger, R.S.: Heart rate and cardiovascular mortality: the Framingham study. Am. Heart J. 113, 1489–1494 (1987)CrossRefGoogle Scholar
  5. 5.
    Gillman, M.W., Kannel, W.B., Belanger, A.: Influence of heart rate on mortality among persons with hypertension: the Framingham study. Am. Heart J. 125, 1148–1154 (1993)CrossRefGoogle Scholar
  6. 6.
    Pickering, T.G., Shimbo, D., Haas, D.: Ambulatory blood-pressure monitoring. N. Engl. J. Med. 354, 2368–2374 (2006)CrossRefGoogle Scholar
  7. 7.
    Mancia, G.: Short- and long-term blood pressure variability: present and future. Hypertension 60, 512–517 (2012)CrossRefGoogle Scholar
  8. 8.
    Palatini, P., Reboldi, G., Beilin, L.J.: Added predictive value of night-time blood pressure variability for cardiovascular events and mortality: the ambulatory blood pressure-international study. Hypertension 64, 487–493 (2014)CrossRefGoogle Scholar
  9. 9.
    Hansen, T., Thijs, L., Boggia, J.: Prognostic value of ambulatory heart rate revisited in 6928 subjects from 6 populations. Hypertension 52, 229–235 (2008)CrossRefGoogle Scholar
  10. 10.
    Palatini, P., Penzo, M., Racioppa, A.: Clinical relevance of nighttime blood pressure and of daytime blood pressure variability. Arch. Intern. Med. 152, 1855–1860 (1992)CrossRefGoogle Scholar
  11. 11.
    Richard, A.M., Nicholls, M.G., Espiner, E.: Diurnal patterns of blood pressure, heart rate and vasoactive hormones in normal man. Clin. Exp. Hypertens. A8, 153–166 (1986)Google Scholar
  12. 12.
    Mancia, G., Ferrari, A., Gregori, L.: Blood pressure and heart rate variabilities in normotensive and hypertensive human beings. Circ. Res. 53, 96–104 (1983)CrossRefGoogle Scholar
  13. 13.
    Littler, W.A., West, M.J., Honour, A.J.: The variability of arterial pressure. Am. Heart J. 95, 180–186 (1978)CrossRefGoogle Scholar
  14. 14.
    Zakopoulos, N., Stamatelopoulos, S.: Effect of hypotensive drugs on the circadian blood pressure pattern in essential hypertension: a comparative study. Cardiovasc. Drugs Therapy 11, 795–799 (1997)CrossRefGoogle Scholar
  15. 15.
    Mancia, G., Fagard, R., Narkiewicz, K.: 2013 ESH/ESC guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European society of hypertension (ESH) and of the European society of cardiology (ESC). Eur. Heart J. 34(28), 2159–2219 (2013)CrossRefGoogle Scholar
  16. 16.
    Koroboki, E., Manios, E., Psaltopoulou, T.: Circadian variation of blood pressure and heart rate in normotensives, white-coat, masked, treated and untreated hypertensives. Hellenic J. Cardiol. 53, 432–438 (2012)Google Scholar
  17. 17.
    Madden, J.M., Li, X., Kearney, P.M.: Exploring diurnal variation using piecewise linear splines: an example using blood pressure. Emerg. Themes Epidemiol. 14(1), 1 (2017)CrossRefGoogle Scholar
  18. 18.
    Millar-Craig, M.W., Bishop, C.N., Rafery, E.B.: Circadian variation in blood pressure. Lancet 1, 795–797 (1978)CrossRefGoogle Scholar
  19. 19.
    Giles, T.D.: Circadian rhythm of blood pressure and the relation to cardiovascular events. J. Hypertens. Suppl. 24, S11–S16 (2006)CrossRefGoogle Scholar
  20. 20.
    Ragot, S., Herpin, D., Siché, J.P.: Relationship between short-term and long-term blood pressure variabilities in essential hypertensive. J. Hum. Hypertens. 15, 41–48 (2001)CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Silveri Giulia
    • 1
    Email author
  • Pascazio Lorenzo
    • 2
  • Sabbadini Gastone
    • 2
  • Guerra Monica
    • 2
  • Accardo Agostino
    • 1
  1. 1.Department of Engineering and ArchitectureUniversity of TriesteTriesteItaly
  2. 2.Department of Medical, Surgical and Health Care, CS of GeriatricsUniversity of TriesteTriesteItaly

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