Defining the nocturnal period in 24-h ambulatory blood pressure monitoring: a comparison of three methods.

Szczegóły
Abstrakt

Tytuł:: Defining the nocturnal period in 24-h ambulatory blood pressure monitoring: a comparison of three methods.
Autorzy:: Slusniene A; State Research Institute Centre for Innovative Medicine.
Navickas P; State Research Institute Centre for Innovative Medicine.; Vilnius University, Faculty of Medicine, Vilnius, Lithuania.
Stankus A; State Research Institute Centre for Innovative Medicine.
Lauceviciene I; Vilnius University, Faculty of Medicine, Vilnius, Lithuania.
Ryliskyte L; Vilnius University, Faculty of Medicine, Vilnius, Lithuania.
Laucevicius A; State Research Institute Centre for Innovative Medicine.
Źródło:: Blood pressure monitoring [Blood Press Monit] 2021 Jun 01; Vol. 26 (3), pp. 207-214.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Publication: <2000->: Hagerstown, MD : Lippincott Williams & Wilkins
Original Publication: London ; Philadelphia, PA : Rapid Science Publishers, c1996-
MeSH Terms:: Blood Pressure Monitoring, Ambulatory*
Hypertension*/diagnosis
Blood Pressure ; Circadian Rhythm ; Humans ; Middle Aged ; Time Factors
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Entry Date(s):: Date Created: 20210120 Date Completed: 20210428 Latest Revision: 20210508
Update Code:: 20240105
DOI:: 10.1097/MBP.0000000000000509
PMID:: 33470645
: Czasopismo naukowe

Objectives: The purpose of our study was to compare three definitions of ambulatory blood pressure (BP) nocturnal period and to assess their agreement in determining nocturnal BP dipping patterns.
Methods: We investigated 69 subjects with metabolic syndrome, aged 50-55 years. In all subjects, we assessed 24-h BP monitoring, electrocardiogram and actigraphy profiles. The nocturnal period was defined in three ways: as a fixed narrow nighttime period from 01:00 to 06:00, as a self-reported sleeping period and as a disappearance and onset of physical activity recorded by the actigraph.
Results: Our study revealed a significant discrepancy between the self-reported and actigraphy-based nocturnal periods (P < 0.001). In addition, different definitions of the nighttime yielded significant differences in determining nondipping, extreme dipping and dipping BP patterns, the identification of the latter being affected the most. The actigraphy-based approach best aligned with the fixed-time determination of the nocturnal period: Cohen's kappa coefficient for the nondipping pattern was 0.78 (0.58-1), for the dipping pattern 0.75 (0.59-0.91) and for the extreme dipping pattern 0.81 (0.65-0.97). In comparison to the self-reported determination of the nocturnal period, using the actigraphy-based approach resulted in reclassifying the nocturnal BP pattern in 20.3% of subjects.
Conclusions: The lack of agreement between fixed-time, self-reported and actigraphy-based determinations of the nighttime period affects the identification of the nocturnal BP patterns. In comparison to the self-reported nocturnal period estimation, the actigraphy-based approach results in the reclassification of BP dipping status in every fifth subject.
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