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Daily life blood pressure changes are steeper in hypertensive than in normotensive subjects

Giuseppe Mancia1, Gianfranco Parati, Paolo Castiglioni

  • 1Dipartimento di Medicina Clinica, Prevenzione e Tecnologie Sanitarie, Università di Milano-Bicocca, Milano and Ospedale San Gerardo, Via Donizetti 106, 20052 Monza. giuseppe.mancia@unimib.it

Hypertension (Dallas, Tex. : 1979)
|July 30, 2003
PubMed

Insights

Hypertensive patients experience steeper blood pressure changes than normotensive individuals. This increased rate of blood pressure fluctuation may contribute to greater arterial wall stress in hypertension.

Area of Science:

  • Cardiovascular Physiology
  • Hypertension Research
  • Biomedical Engineering

Background:

  • Hypertension is linked to target organ damage, associated with elevated average blood pressure and 24-hour blood pressure variability.
  • The rate of blood pressure change in hypertensive individuals and its impact on arterial stress remain underexplored.

Purpose of the Study:

  • To investigate whether the rate of blood pressure changes, specifically systolic blood pressure ramps, is greater in hypertensive subjects compared to normotensive individuals.
  • To assess the potential clinical implications of steeper blood pressure changes on arterial wall stress in hypertension.

Main Methods:

  • Computer analysis of 24-hour ambulatory intra-arterial blood pressure recordings.
  • Inclusion of 34 subjects: 13 normotensive and 21 uncomplicated hypertensive.
  • Computation of systolic blood pressure ramp number, slope (mm Hg/s), and length (beats) over 24 hours.

Main Results:

  • Hypertensive subjects exhibited a markedly steeper systolic blood pressure ramp slope (6.50 mm Hg/s) compared to normotensive subjects (4.80 mm Hg/s).
  • The number and length of systolic blood pressure ramps were similar between the two groups.
  • Ramp slope was positively correlated with higher initial systolic blood pressure values.

Conclusions:

  • Hypertensive individuals demonstrate steeper blood pressure changes during daily life compared to normotensive individuals.
  • These steeper blood pressure fluctuations may induce greater traumatic effects on the vessel walls in hypertensive patients.
  • The findings suggest a novel mechanism contributing to target organ damage in hypertension.

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