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Impact of various night-time period definitions on nocturnal ambulatory blood pressure


Nolde, JM and Hillis, GS and Atkins, E and Von Huben, A and Marschner, S and Chan, J and Reid, CM and Nelson, MR and Figtree, G and Chalmers, J and Usherwood, T and Rodgers, A and Chow, CK and Schlaich, MP, Impact of various night-time period definitions on nocturnal ambulatory blood pressure, Journal of Hypertension, 40, (11) pp. 2271-2279. ISSN 0263-6352 (2022) [Refereed Article]

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DOI: doi:10.1097/HJH.0000000000003255


Background: Several definitions of night-time BP exist for the calculation of nocturnal blood pressure (BP) based on 24-h BP measurements. How much these methods differ regarding the resulting nocturnal blood pressure values, under which circumstances these differences become clinically meaningful, and under which circumstances diary-adjusted measurements should be used preferentially remains uncertain.

Methods: Data of 512 24-h BP recordings were analysed regarding differences in nocturnal BP based on three alternative definitions of night-time: 2300-0700 h, 0100-0500 h, and diary-adjusted measures.

Results: Mean systolic nocturnal BP between 2300-0700 h was 2.5 mmHg higher than between 0100 and 0500 h and 1.6 mmHg higher than diary adjusted estimates. Up to 38.3% of individuals showed BP differences of more than 5 mmHg when comparing temporal definitions of night-time, resulting in significant proportions of individuals being re-classified as hypertensive. When diary-derived sleeping patterns differed by less than 2 h from the 2300 to 0700 h fixed time definition, mean BP discrepancies remained below 3 mmHg. Absolute time discrepancies between diary and 2300-0700 h fixed time definition of 2-4, 4-8 or at least 8 h led to SBP/DBP differences of 4.1/3.1, 6.8/6.1, and 14.5/9.1mmHg, respectively.

Conclusion: Average differences of nocturnal BP between varying definitions in study/cohort data are small and would be of limited relevance in many settings. However, substantial differences can be observed in individual cases, which may affect clinical decision-making in specific patients. In patients whose sleeping patterns differs by more than 2 h from defined fixed night-times, diaries should be used for adjustment.

Item Details

Item Type:Refereed Article
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Cardiology (incl. cardiovascular diseases)
Objective Division:Health
Objective Group:Clinical health
Objective Field:Diagnosis of human diseases and conditions
UTAS Author:Nelson, MR (Professor Mark Nelson)
ID Code:155646
Year Published:2022
Deposited By:Menzies Institute for Medical Research
Deposited On:2023-03-03
Last Modified:2023-03-03

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