L. Thijs et al., DIURNAL BLOOD-PRESSURE PROFILE IN OLDER PATIENTS WITH ISOLATED SYSTOLIC HYPERTENSION, Journal of human hypertension, 9(11), 1995, pp. 917-924
This study describes the diurnal blood pressure (BP) profile and ident
ifies its correlates in older patients with isolated systolic hyperten
sion (ISH). The ambulatory BP readings of 408 patients, aged greater t
han or equal to 60 years, with ISH on clinic measurement, enrolled in
the placebo run-in phase of the Syst-Eur Trial were examined. The time
-weighted 24 h BP, daytime and night-time BP and the cusum-derived cre
st and trough BP were computed to express the BP level. The daily alte
ration between the high and low BP span was estimated from the day-nig
ht BP difference, the cusum derived circadian alteration magnitude and
plot height, as well as the amplitude of the Fourier curve. The 24 h
SEP and DBP tended to be higher in men (150 +/- 15/82 +/- 9 mm Hg) tha
n in women (147 +/- 17/79 +/- 10 mm Hg), but the sex difference was on
ly significant for DBP. In multiple regression analysis, the 24 h SEP
increased (P< 0.05) by 3 mm Hg for each 10 year increment in age and w
as also 10 mm Hg higher (P< 0.001) in smokers than in non-smokers; the
24 h DBP was 2 mm Hg higher (P< 0.05) in men than in women and decrea
sed (P< 0.05) by 1.5 mm Hg for each 10 year increment in age. The day-
night difference in SBP increased with 2 mm Hg for each 10 mm Hg incre
ase in the conventional pressure, decreased with 5 mm Hg for each 10 y
ear increment in age and was 6 mm Hg higher in smokers than in non-smo
kers; the day-night difference in diastolic pressure was 2 mm Hg great
er in women than in men. We conclude that the main determinants of the
diurnal BP variation in older patients with isolated systolic hyperte
nsion were sex, age, smoking habits and the level of pressure on conve
ntional measurement.