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Am J Hypertens. 2016 Jun;29(6):737-46. doi: 10.1093/ajh/hpv169. Epub 2015 Oct 16.

The Diurnal Profile of Central Hemodynamics in a General Uruguayan Population.

Author information

1
Unidad de Hipertensión Arterial, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay; Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay; Centro de Nefrología, Universidad de la República, Montevideo, Uruguay; jboggia@hc.edu.uy.
2
Unidad de Hipertensión Arterial, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay; Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay; Centro de Nefrología, Universidad de la República, Montevideo, Uruguay;
3
Unidad de Hipertensión Arterial, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay; Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay;
4
Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium;
5
Departamento de Laboratorio Clínico, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay;
6
Unidad de Hipertensión Arterial, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay; Centro de Nefrología, Universidad de la República, Montevideo, Uruguay;
7
Department of Pharmacology, Maastricht University, Maastricht, The Netherlands;
8
Faculty of Medicine, Hôtel-Dieu Hospital, Paris-Descartes University, Paris, France;
9
Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium; R & D VitaK Group, Maastricht University, Maastricht, The Netherlands.

Abstract

BACKGROUND:

No previous population study assessed the diurnal profile of central arterial properties.

METHODS:

In 167 participants (mean age, 56.1 years; 63.5% women), randomly recruited in Montevideo, Uruguay, we used the oscillometric Mobil-O-Graph 24-h PWA monitor to measure peripheral and central systolic (SBP), diastolic (DBP), and pulse (PP) pressures and central hemodynamics standardized to a heart rate of 75 bpm, including aortic pulse wave velocity, systolic augmentation (first/second peak × 100), and pressure amplification (peripheral PP/central PP).

RESULTS:

Over 24 hours, day and night, peripheral minus central differences in SBP/DBP and in PP averaged 12.2/-1.1, 14.0/-0.7, and 9.7/0.2mm Hg and 12.6, 14.7, and 9.5mm Hg, respectively (P < 0.001 except for nighttime DBP (P = 0.38)). The central-to-peripheral ratios of SBP, DBP, and PP were 0.89, 1.00, and 0.70 unadjusted, but after accounting for anthropometric characteristics decreased to 0.74, 0.97, and 0.63, respectively, with strong influence of height for SBP and DBP and of sex for PP. From day (10-20h) to nighttime (0-6h), peripheral (-10.4/-10.5 mm Hg) and central (-6.0/-11.3mm Hg) SBP/DBP, pulse wave velocity (-0.7 m/s) and pressure amplification (-0.05) decreased (P < 0.001), whereas central PP (+5.3mm Hg) and systolic augmentation (+2.3%) increased (P < 0.001).

CONCLUSIONS:

The diurnal rhythm of central pressure runs in parallel with that of peripheral pressure, but the nocturnal fall in SBP is smaller centrally than peripherally. pulse wave velocity, systolic augmentation, and pressure amplification loop through the day with high pulse wave velocity and pressure amplification but low systolic augmentation in the evening and opposite trends in the morning.

KEYWORDS:

aortic pulse wave velocity; arterial stiffness; blood pressure monitoring; central blood pressure; hypertension; population science.

PMID:
26476084
DOI:
10.1093/ajh/hpv169
[Indexed for MEDLINE]

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