Impact of various night-time period definitions on nocturnal ambulatory blood pressure

Janis M Nolde; Graham S Hillis; Emily Atkins; Amy Von Huben; Simone Marschner; Justine Chan; Christopher M Reid; Mark R Nelson; Gemma Figtree; John Chalmers; Tim Usherwood; Anthony Rodgers; Clara K Chow; Markus P Schlaich

doi:10.1097/HJH.0000000000003255

Impact of various night-time period definitions on nocturnal ambulatory blood pressure

Janis M Nolde, Graham S Hillis, Emily Atkins, Amy Von Huben, Simone Marschner, Justine Chan, Christopher M Reid, Mark R Nelson, Gemma Figtree, John Chalmers, Tim Usherwood, Anthony Rodgers, Clara K Chow, Markus P Schlaich

Research output: Contribution to journal › Article › peer-review

4 Citations (Scopus)

Abstract

BACKGROUND: Several definitions of night-time BP exist for the calculation of nocturnal blood pressure (BP) based on 24-h BP measurements. How much these methods differ regarding the resulting nocturnal blood pressure values, under which circumstances these differences become clinically meaningful, and under which circumstances diary-adjusted measurements should be used preferentially remains uncertain.

METHODS: Data of 512 24-h BP recordings were analysed regarding differences in nocturnal BP based on three alternative definitions of night-time: 2300-0700 h, 0100-0500 h, and diary-adjusted measures.

RESULTS: Mean systolic nocturnal BP between 2300-0700 h was 2.5 mmHg higher than between 0100 and 0500 h and 1.6 mmHg higher than diary adjusted estimates. Up to 38.3% of individuals showed BP differences of more than 5 mmHg when comparing temporal definitions of night-time, resulting in significant proportions of individuals being re-classified as hypertensive. When diary-derived sleeping patterns differed by less than 2 h from the 2300 to 0700 h fixed time definition, mean BP discrepancies remained below 3 mmHg. Absolute time discrepancies between diary and 2300-0700 h fixed time definition of 2-4, 4-8 or at least 8 h led to SBP/DBP differences of 4.1/3.1, 6.8/6.1, and 14.5/9.1mmHg, respectively.

CONCLUSION: Average differences of nocturnal BP between varying definitions in study/cohort data are small and would be of limited relevance in many settings. However, substantial differences can be observed in individual cases, which may affect clinical decision-making in specific patients. In patients whose sleeping patterns differs by more than 2 h from defined fixed night-times, diaries should be used for adjustment.

GRAPHICAL ABSTRACT: http://links.lww.com/HJH/C44.

Original language	English
Pages (from-to)	2271-2279
Number of pages	9
Journal	Journal of Hypertension
Volume	40
Issue number	11
DOIs	https://doi.org/10.1097/HJH.0000000000003255
Publication status	Published - 1 Nov 2022

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Nolde, J. M., Hillis, G. S., Atkins, E., Von Huben, A., Marschner, S., Chan, J., Reid, C. M., Nelson, M. R., Figtree, G., Chalmers, J., Usherwood, T., Rodgers, A., Chow, C. K., & Schlaich, M. P. (2022). Impact of various night-time period definitions on nocturnal ambulatory blood pressure. Journal of Hypertension, 40(11), 2271-2279. https://doi.org/10.1097/HJH.0000000000003255

@article{c62568543dfa4784b241ed1e4ccbc5ab,

title = "Impact of various night-time period definitions on nocturnal ambulatory blood pressure",

abstract = "BACKGROUND: Several definitions of night-time BP exist for the calculation of nocturnal blood pressure (BP) based on 24-h BP measurements. How much these methods differ regarding the resulting nocturnal blood pressure values, under which circumstances these differences become clinically meaningful, and under which circumstances diary-adjusted measurements should be used preferentially remains uncertain.METHODS: Data of 512 24-h BP recordings were analysed regarding differences in nocturnal BP based on three alternative definitions of night-time: 2300-0700 h, 0100-0500 h, and diary-adjusted measures.RESULTS: Mean systolic nocturnal BP between 2300-0700 h was 2.5 mmHg higher than between 0100 and 0500 h and 1.6 mmHg higher than diary adjusted estimates. Up to 38.3% of individuals showed BP differences of more than 5 mmHg when comparing temporal definitions of night-time, resulting in significant proportions of individuals being re-classified as hypertensive. When diary-derived sleeping patterns differed by less than 2 h from the 2300 to 0700 h fixed time definition, mean BP discrepancies remained below 3 mmHg. Absolute time discrepancies between diary and 2300-0700 h fixed time definition of 2-4, 4-8 or at least 8 h led to SBP/DBP differences of 4.1/3.1, 6.8/6.1, and 14.5/9.1mmHg, respectively.CONCLUSION: Average differences of nocturnal BP between varying definitions in study/cohort data are small and would be of limited relevance in many settings. However, substantial differences can be observed in individual cases, which may affect clinical decision-making in specific patients. In patients whose sleeping patterns differs by more than 2 h from defined fixed night-times, diaries should be used for adjustment.GRAPHICAL ABSTRACT: http://links.lww.com/HJH/C44.",

author = "Nolde, {Janis M} and Hillis, {Graham S} and Emily Atkins and {Von Huben}, Amy and Simone Marschner and Justine Chan and Reid, {Christopher M} and Nelson, {Mark R} and Gemma Figtree and John Chalmers and Tim Usherwood and Anthony Rodgers and Chow, {Clara K} and Schlaich, {Markus P}",

year = "2022",

month = nov,

day = "1",

doi = "10.1097/HJH.0000000000003255",

language = "English",

volume = "40",

pages = "2271--2279",

journal = "Journal of Hypertension",

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number = "11",

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TY - JOUR

T1 - Impact of various night-time period definitions on nocturnal ambulatory blood pressure

AU - Nolde, Janis M

AU - Hillis, Graham S

AU - Atkins, Emily

AU - Von Huben, Amy

AU - Marschner, Simone

AU - Chan, Justine

AU - Reid, Christopher M

AU - Nelson, Mark R

AU - Figtree, Gemma

AU - Chalmers, John

AU - Usherwood, Tim

AU - Rodgers, Anthony

AU - Chow, Clara K

AU - Schlaich, Markus P

PY - 2022/11/1

Y1 - 2022/11/1

N2 - BACKGROUND: Several definitions of night-time BP exist for the calculation of nocturnal blood pressure (BP) based on 24-h BP measurements. How much these methods differ regarding the resulting nocturnal blood pressure values, under which circumstances these differences become clinically meaningful, and under which circumstances diary-adjusted measurements should be used preferentially remains uncertain.METHODS: Data of 512 24-h BP recordings were analysed regarding differences in nocturnal BP based on three alternative definitions of night-time: 2300-0700 h, 0100-0500 h, and diary-adjusted measures.RESULTS: Mean systolic nocturnal BP between 2300-0700 h was 2.5 mmHg higher than between 0100 and 0500 h and 1.6 mmHg higher than diary adjusted estimates. Up to 38.3% of individuals showed BP differences of more than 5 mmHg when comparing temporal definitions of night-time, resulting in significant proportions of individuals being re-classified as hypertensive. When diary-derived sleeping patterns differed by less than 2 h from the 2300 to 0700 h fixed time definition, mean BP discrepancies remained below 3 mmHg. Absolute time discrepancies between diary and 2300-0700 h fixed time definition of 2-4, 4-8 or at least 8 h led to SBP/DBP differences of 4.1/3.1, 6.8/6.1, and 14.5/9.1mmHg, respectively.CONCLUSION: Average differences of nocturnal BP between varying definitions in study/cohort data are small and would be of limited relevance in many settings. However, substantial differences can be observed in individual cases, which may affect clinical decision-making in specific patients. In patients whose sleeping patterns differs by more than 2 h from defined fixed night-times, diaries should be used for adjustment.GRAPHICAL ABSTRACT: http://links.lww.com/HJH/C44.

AB - BACKGROUND: Several definitions of night-time BP exist for the calculation of nocturnal blood pressure (BP) based on 24-h BP measurements. How much these methods differ regarding the resulting nocturnal blood pressure values, under which circumstances these differences become clinically meaningful, and under which circumstances diary-adjusted measurements should be used preferentially remains uncertain.METHODS: Data of 512 24-h BP recordings were analysed regarding differences in nocturnal BP based on three alternative definitions of night-time: 2300-0700 h, 0100-0500 h, and diary-adjusted measures.RESULTS: Mean systolic nocturnal BP between 2300-0700 h was 2.5 mmHg higher than between 0100 and 0500 h and 1.6 mmHg higher than diary adjusted estimates. Up to 38.3% of individuals showed BP differences of more than 5 mmHg when comparing temporal definitions of night-time, resulting in significant proportions of individuals being re-classified as hypertensive. When diary-derived sleeping patterns differed by less than 2 h from the 2300 to 0700 h fixed time definition, mean BP discrepancies remained below 3 mmHg. Absolute time discrepancies between diary and 2300-0700 h fixed time definition of 2-4, 4-8 or at least 8 h led to SBP/DBP differences of 4.1/3.1, 6.8/6.1, and 14.5/9.1mmHg, respectively.CONCLUSION: Average differences of nocturnal BP between varying definitions in study/cohort data are small and would be of limited relevance in many settings. However, substantial differences can be observed in individual cases, which may affect clinical decision-making in specific patients. In patients whose sleeping patterns differs by more than 2 h from defined fixed night-times, diaries should be used for adjustment.GRAPHICAL ABSTRACT: http://links.lww.com/HJH/C44.

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U2 - 10.1097/HJH.0000000000003255

DO - 10.1097/HJH.0000000000003255

M3 - Article

C2 - 35983855

SN - 0263-6352

VL - 40

SP - 2271

EP - 2279

JO - Journal of Hypertension

JF - Journal of Hypertension

IS - 11

ER -

Impact of various night-time period definitions on nocturnal ambulatory blood pressure

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