AMBULATORY BLOOD-PRESSURE MONITORING FOR EVALUATING THE RELATIONSHIPSBETWEEN LIFE-STYLE, HYPERTENSION AND CARDIOVASCULAR RISK

1. Ambulatory monitoring provides a unique opportunity for studying th e temporal relationships between lifestyle factors and blood pressure (BP), These include physical activity, mental activity, environmental stressors, substances ingested for pleasure such as smoking, alcohol a nd caffeine, and nutrition. 2. Changes in physical activity play a maj or role in determining the diurnal profile of BP, whereas the influenc e of mood is small. 3. Environmental stress, in the form of job strain , has been shown to be associated with a sustained increase of BP thro ughout the day and night in men, and also with an increased left ventr icular mass. The effects are most marked in men who drink alcohol regu larly, Job strain does not appear to influence BP in women. 4. Althoug h it is recognized that smoking raises BP acutely, its long-term effec ts have been unclear, Ambulatory monitoring shows that smokers have a larger diurnal swing of BP than non-smokers, because of a higher dayti me pressure, Alcohol also increases the diurnal swing of BP. 5. Ambula tory monitoring has been used relatively little for evaluating nutriti onal factors, but has the possibility of quantifying their effects on BP more reliably than traditional methods, and also elucidating the un derlying mechanisms.