Elevated blood pressure in primary care varies in relation to circadian and seasonal changes.
J Hum Hypertens
; 22(11): 755-60, 2008 Nov.
Article
in En
| MEDLINE
| ID: mdl-18528410
ABSTRACT
Blood pressure (BP) is known to vary by time of day and day of year. Studies differ substantially on the magnitude of the effect and there is doubt whether variation is clinically meaningful. We used more than 2 million BP measurements obtained between 1996 and 2004 from Geisinger Clinic primary care patients. General estimating equations were used to determine the effect of time of day and month of year on the probability of identifying BP values above four diagnostic cutoff points (SBP > or =120 mm Hg, SBP > or =140 mm Hg, DBP > or =80 mm Hg, DBP > or =90 mm Hg). Time of day and month of year were significantly associated with the odds of measuring elevated BP, regardless of definition. The odds ratio (OR) for SBP > or =120 mm Hg in the evening (1900 hours) versus midday (1200 hours) was 1.32 (P < 0.001). The OR for SBP > or =120 mm Hg in winter to summer months was 1.24 (P < 0.001). Similar results were found for each age/gender group. These data indicate that in clinical practice, measurement of an elevated BP may vary by 40% depending on the time of day and month of year. The magnitude of the variability in BP measurement attributable to the combined effect of these temporal factors is clinically significant. Anticipation of changes in BP attributable to temporal factors may improve accuracy of diagnosis and precision of therapy.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Primary Health Care
/
Seasons
/
Blood Pressure
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Circadian Rhythm
/
Hypertension
Type of study:
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Adult
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Aged
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Aged80
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Female
/
Humans
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Male
/
Middle aged
Country/Region as subject:
America do norte
Language:
En
Journal:
J Hum Hypertens
Journal subject:
ANGIOLOGIA
Year:
2008
Type:
Article
Affiliation country:
United States