Daytime actisensitivity predicts nocturnal dipping patterns and morning surge in blood pressure: the Home-Activity ICT-based Japan Ambulatory Blood Pressure Monitoring Prospective study.

IF 3.3 2区 医学 Q1 PERIPHERAL VASCULAR DISEASE Journal of Hypertension Pub Date : 2024-12-01 Epub Date: 2024-08-30 DOI:10.1097/HJH.0000000000003862
Naoko Tomitani, Satoshi Hoshide, Hiroshi Kanegae, Kazuomi Kario
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Abstract

Background: Ambulatory blood pressure (BP) is influenced by physical activity and the BP response to physical activity (actisensitivity) differs between individuals. This study investigated associations between daytime actisensitivity and nighttime BP dipping status and morning BP surge.

Methods: Twenty-four-hour ambulatory BP monitoring (ABPM) with simultaneously monitored physical activity using a multisensor all-in-one device (TM-2441; A&D Company) was performed at baseline in HI-JAMP study participants. Those with complete BP measurements and complete physical activity monitoring data were included in this analysis. Actisensitivity was calculated as the slope of the regression line between daytime SBP and log-transformed physical activity over a 5 min period before each BP reading. Hyper and negative reactivity were defined as actisensitivity greater than 90th and less than 10th percentile, respectively.

Results: Data from 2692 individuals (mean age 69.9 ± 11.9 years; mean BMI 24.8 ± 4.1 kg/m 2 , 53.6% men) were analyzed. Those with hyper reactivity had a high prevalence of the extreme dipper pattern of nighttime BP and exaggerated morning BP surge; those with negative reactivity had higher nighttime BP and a riser pattern of nighttime BP. Results remained significant after adjusting for 24-h physical activity. Differences in diurnal BP variability based on actisensitivity were augmented in individuals aged at least 75 years.

Conclusion: This study is the first to investigate associations between actisensitivity and 24-h ambulatory BP profiles using an all-in-one multisensor device in a large real-world population. The associations seen between either hyper or negative actisensitivity and abnormal diurnal BP variability, especially in the elderly, could contribute to increased cardiovascular event risk.

Clinical trial registration: University Hospital Medical Information Network Clinical Trials Registry, UMIN000029151 (HI-JAMP study).

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日间活动敏感性可预测夜间血压下降模式和清晨血压骤升:基于家庭活动信息和通信技术的日本非卧床血压监测前瞻性研究。
背景:非卧床血压(BP)受体力活动的影响,不同个体对体力活动的血压反应(活动敏感性)也不同。本研究调查了白天活动敏感性和夜间血压下降状态与早晨血压骤升之间的关系:方法:HI-JAMP 研究参与者在基线时使用多传感器一体化设备(TM-2441;A&D 公司)进行 24 小时动态血压监测(ABPM),并同时监测体力活动。具有完整血压测量数据和完整体力活动监测数据的参与者被纳入本次分析。活动敏感性根据每次血压读数前 5 分钟内白天 SBP 与对数变换后的体力活动之间的回归线斜率计算。高反应性和负反应性分别定义为活动敏感性大于第 90 百分位数和小于第 10 百分位数:分析了 2692 人(平均年龄 69.9 ± 11.9 岁;平均体重指数 24.8 ± 4.1 kg/m2,53.6% 为男性)的数据。反应亢进者夜间血压呈极度下降模式,且早晨血压激增;反应消极者夜间血压较高,且夜间血压呈上升模式。在对 24 小时体力活动进行调整后,结果仍然显著。在至少 75 岁的人群中,基于行为敏感性的昼夜血压变异性差异更大:这项研究首次在现实世界的大量人群中使用一体化多传感器设备调查了动作敏感性与 24 小时动态血压曲线之间的关联。无论是高动敏还是负动敏,都与血压昼夜变化异常有关,尤其是在老年人中,这可能会增加心血管事件的风险:临床试验注册:大学医院医学信息网临床试验注册,UMIN000029151(HI-JAMP 研究)。
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来源期刊
Journal of Hypertension
Journal of Hypertension 医学-外周血管病
CiteScore
7.90
自引率
6.10%
发文量
1389
审稿时长
3 months
期刊介绍: The Journal of Hypertension publishes papers reporting original clinical and experimental research which are of a high standard and which contribute to the advancement of knowledge in the field of hypertension. The Journal publishes full papers, reviews or editorials (normally by invitation), and correspondence.
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