Related Experiment Video
Updated: Sep 14, 2025
Software for Analysis of Heart Rate and Blood Pressure Time-series Data from the Valsalva Maneuver
Published on: June 27, 2025
Interrelationship Between the Morning-to-Evening Changes in Home Blood Pressure and Pulse Rate
Jia-Bo Zhu1, Qian-Hui Guo1, Yi Zhou1
1Department of Cardiovascular Medicine, Centre for Epidemiological Studies and Clinical Trials, Shanghai Key Laboratory of Hypertension, The Shanghai Institute of Hypertension, National Research Centre for Translational Medicine at Shanghai, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Insights
Home blood pressure (BP) drops in the evening while pulse rate rises. Significant changes in pulse rate are linked to poorer BP control in hypertensive patients.
Area of Science:
- Cardiology
- Hypertension Management
- Chronobiology
Background:
- Hypertension is a global health concern requiring continuous monitoring.
- Understanding diurnal variations in blood pressure (BP) and pulse rate is crucial for effective management.
- Home BP monitoring provides valuable insights into daily BP fluctuations.
Purpose of the Study:
- To investigate morning-to-evening changes in home BP and pulse rate.
- To identify demographic and clinical factors influencing these diurnal variations.
- To explore the interrelationship between BP and pulse rate changes and their association with BP control in treated hypertensive patients.
Main Methods:
- Cross-sectional analysis of 4787 hypertensive patients (≥55 years) from a China nationwide registry.
- Home BP and pulse rate measured thrice daily for seven consecutive days.
- Diurnal changes calculated by subtracting morning from evening values.
Main Results:
- Systolic/diastolic BP decreased by -1.9/-1.8 mmHg from morning to evening.
- Pulse rate increased by +3.1 beats/min from morning to evening.
- Higher pulse rate increase was negatively associated with BP changes and linked to lower BP control rates (60.1% vs. 65.5%).
Conclusions:
- Interrelated diurnal variations exist between home BP and pulse rate.
- A drop in BP and a rise in pulse rate were observed from morning to evening.
- These diurnal patterns may have implications for hypertension management and BP control.
Background:
We investigated the morning-to-evening changes in home blood pressure (BP) and pulse rate for demographic and clinical determinants, interrelationship, and association with BP control in treated patients with hypertension.
Methods:
We performed a cross-sectional analysis in patients (≥55 years of age) with hypertension, enrolled in a China nationwide registry on home BP monitoring between 2020 and 2025. Home BP was measured three times consecutively in the morning and evening, respectively, for seven consecutive days. The change was calculated by subtracting the BP and pulse rate values in the morning from those in the evening.
Results:
The 4,787 participants had a mean (±SD) age of 66.1 (±7.5) years, and included 2,366 (49.4%) men. Overall, systolic/diastolic BP decreased from 129.1/80.6 mmHg in the morning to 127.2/78.7 mmHg in the evening by a mean change of -1.9 ± 7.8/-1.8 ± 4.7 mmHg. Pulse rate, however, increased from 70.5 beats/min in the morning to 73.7 beats/min in the evening by a mean change of +3.1 ± 5.8 beats/min. Adjusted analyses showed that the changes in pulse rate were negatively associated with those in both systolic (r = -0.20, 95% CI: -0.22 to -0.17) and diastolic BP (r = -0.12, 95% CI: -0.14 to -0.09). Patients with a change in pulse rate above the median (≥3.0 beats/min) had a lower control rate of office systolic/diastolic BP (60.1% vs. 65.5%, P < 0.001) than those with a change in pulse rate below the median.
Conclusions:
There were interrelated morning-to-evening changes in home BP and pulse rate, being a drop and rise, respectively.
Related Concept Videos
01:15Chronopharmacokinetics: Circadian Rhythms and Influence on Drug Response
The time of drug administration is an important factor to consider, as it can influence the toxic dose of a drug. For example, a study conducted by Prins et al. in 1997 examined the effects of the timing of...
01:17Measurement of Blood Pressure
01:28Factors affecting Blood pressure
Physiological Factors:
01:28Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
01:24Blood Pressure
01:16Pulse
The pulse serves as a clinical...