INFLUENCE OF ACTIVITIES AND EMOTIONAL-STRESS ON AMBULATORY BLOOD-PRESSURE

The influence of daily activities and emotional stress on ambulatory b lood pressure (ABP) monitoring in two groups of patients is described, Sixty-seven consecutive patients were divided into two groups accordi ng to their conventional blood pressure (BP) levels: the hypertensive group and white coat hypertension group. Both groups were not previous ly treated with antihypertensive drugs, All patients underwent 24-h AB P monitoring and marked their activity and mood at the time of measure ment in a diary, The Spacelabs 90202 ABP oscillometric monitors (Space labs, Inc.) were used, In the hypertensive group, 66% of patients were hypertensive (24 h average 144 +/- 22/88 +/- 14 mm Hg), while in the white coat hypertension group 25% of ABP monitorings were hypertensive (128 +/- 17/80 +/- 13 mm Hg). Diary data were analyzed with the multi ple regression analysis to evaluate the quantitative effects of activi ties and mood on the variability of BP, The standardized BP values of each patient were used, Statistical analysis accounted for 37.8 and 32 .4% of variability for the systolic BP in the hypertensive and white c oat hypertension group and for 38.6 and 33.8% of diastolic BP, respect ively, Only a minor part of BP variability was explained with regular cyclic functions (the circadian rhythm). Typically 8 to 9 independent covariates entered the stepwise multiple regression analysis, The most important covariates of BP in both groups were body position and loca tion of patient (''at job,'' ''outside''). Different activities and mo od of the patient influence ABP, It is important to consider various l evels of activity and emotional stress in the evaluation of ABP monito ring.