K. Otsuka et al., EXCESSIVE CIRCADIAN AMPLITUDE OF BLOOD-PRESSURE INCREASES RISK OF ISCHEMIC STROKE AND NEPHROPATHY, Journal of medical engineering & technology, 21(1), 1997, pp. 23-30
After 48-h ambulatory blood pressure monitoring, the incidence of isch
aemic stroke, nephropathy, coronary heart disease and retinopathy was
prospectively assessed for 6 years in 297 subjects, including 176 trea
ted patients with an elevated blood pressure mean (MESOR-hypertensives
). The relative risk associated with an excessive circadian blood pres
sure amplitude is 8.2 (95% confidence interval 3.1 to 21.7; p < 0.001)
for ischaemic stroke and 6.9 (2.9 to 16.3; p < 0.001) for nephropathy
. In MESOR-hypertensives, the relative risk for ischaemic stroke and n
ephropathy is 6.3 (p < 0.005) and 4.0 (p < 0.05), respectively. In MES
OR-normotensives as well, an excessive circadian blood pressure amplit
ude is associated with a large increase in risk for ischaemic stroke a
nd nephropathy (p < 0.05). An excessive circadian blood pressure ampli
tude is an entity in its own right that increases the risk of adverse
vascular events irrespective of the blood pressure MESOR, age and the
presence of other known risk factors. The diagnosis of this condition
requires around-the-clock monitoring of blood pressure. The treatment
of patients with this condition should aim not only at lowering the bl
ood pressure mean but also at reducing blood pressure variability with
24 h.