Does nondipping of blood pressure at night reflect a trait of blunted cardiovascular responses to daily activities? |
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Authors: | Räikkönen Katri Matthews Karen A. Kondwani Kofi A. Bunker Clareann H. Melhem Nadine M. Ukoli Flora A. M. Asogun A. Jacob Rolf G. |
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Affiliation: | (1) University of Helsinki, USA;(2) Department of Psychiatry, 3811 O’Hara Street, 15213 Pittsburgh, PA;(3) Departments of Psychiatry and Otolaryngology, University of Pittsburgh School of Medicine, USA;(4) Morehouse School of Medicine, USA;(5) Graduate School of Public Health, University of Pittsburgh, USA;(6) University of Benin Teaching Hospital, USA |
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Abstract: | Background: Individuals who fail to show a decline in blood pressure (BP) when asleep or at night (labeled nocturnal nondippers) are at elevated risk for hypertension and associated targetorgan damage.Purpose: We tested whether the well-established changes in BP exhibited in response to daily activities are also blunted in nocturnal nondippers.Methods: Cross-sectional study of 41 women and 56 men, aged 27 to 71 years, residing in Benin, Nigeria, enrolled in a health survey of civil servants. Ambulatory 24-hr BP monitoring was performed with concurrent diary recordings of physical activity level, posture, location, state of mental activity, interpersonal interaction, and mood obtained during the waking hours.Results: Nocturnal nondippers exhibited smaller cardiovascular responses to changes in posture (from lying to sitting or to standing, ps <.02), location (from home to work or to driving/riding in a car, ps < .02), mental activity (from relaxed to active, p =. 02), and mood (from feeling mellow to feeling elated-happy, p = .05) than did dippers. Statistical controls for posture substantially reduced the effects of nondipping status on responses to other daily activities and mood. Lack of systolic BP responsiveness to postural changes during the day is a strong predictor of nondipping status.Conclusions: Nondipping at night appears to extend to decreased cardiovascular responses to changes in activities during daytime hours. This work was supported by National Institutes of Health Grants HL44413 andHL44413-S1. |
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