Assessment of body position to quantify its effect on nocturnal blood pressure under ambulatory conditions
作者:
Marinel Cavelaars,
Joke Tulen,
Arie Man in 't Veld,
Edzard Gelsema,
Anton van den Meiracker,
期刊:
Journal of Hypertension
(OVID Available online 2000)
卷期:
Volume 18,
issue 12
页码: 1737-1743
ISSN:0263-6352
年代: 2000
出版商: OVID
关键词: ambulatory blood pressure;posture;nocturnal blood pressure decrease;reproducibility
数据来源: OVID
摘要:
BackgroundNocturnal blood pressure readings may be influenced by body position because of variation in the vertical distance between heart and cuff level.ObjectivesTo quantify the effect of body position on nocturnal blood pressure and to assess whether this effect influences the reproducibility of nocturnal blood pressure.Patients and methodsIn 16 individuals (three normotensive and 13 hypertensive) 24 h ambulatory measurement of blood pressure and body position was performed twice, separated by an interval of 2–6 weeks. Body position was measured with five acceleration sensors, which were mounted on the trunk and legs.ResultsDuring the first night, 43 ± 31% of blood pressure values were measured while participants were in the supine position, 29 ± 28% when they were lying on their side with the cuffed arm down and 28 ± 29% when they were lying on their side with the cuffed arm up. During the second night these percentages were 40 ± 29%, 32 ± 29% and 28 ± 25% respectively. Blood pressure readings obtained while individuals were lying with the cuffed arm up were about 10 mmHg lower than those obtained with the individual in either the supine position or lying with the cuffed arm down. After correction for the underestimation attributable to ‘cuff-up’ readings, nocturnal blood pressure increased by 3 mmHg and the number of non-dippers increased from two to four. Correction did not affect the reproducibility of nocturnal blood pressure measurements (standard deviation of the differences 8.3 mmHg for systolic and 6.0 mmHg for diastolic blood pressure after correction). Dipping status was reproduced in 88% of individuals before correction, and in 87% after correction.ConclusionsUnder ambulatory conditions, a highly variable but sometimes substantial number of blood pressure readings are taken with the cuffed arm above heart level. These readings result in underestimation of nocturnal blood pressure and hence influence dipper-non-dipper classification. However, body position does not seem to have an important influence on the reproducibility of nocturnal blood pressure or dipping status.
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