Reproducibility of blood pressure dipping: relation to day-to-day variability in sleep quality.

Journal Article (Clinical Trial;Journal Article)

Previous studies of the reproducibility of blood pressure (BP) dipping have yielded inconsistent results. Few have examined factors that may influence day-to-day differences in dipping. Ambulatory BP monitoring was performed on three occasions, approximately 1 week apart, in 115 untreated adult subjects with elevated clinic BPs. The mean ± standard deviation BP dip was 18 ± 7/15 ± 5 mm Hg (sleep/awake BP ratio = 0.87 ± 0.05/0.82 ± 0.06), with a median (interquartile range) day-to-day variation of 5.2 (3.1-8.1)/4.3 (2.8-5.6) mm Hg. There was no decrease in variability with successive measurements. The reproducibility coefficient (5.6 [95% confidence interval, 5.1-6.1] mm Hg) was greater and the intraclass correlation coefficient (0.53 [95% confidence interval, 0.42-0.63]) was smaller for the systolic dip than for 24-hour or awake systolic BPs, suggesting greater day-to-day variability in dipping. Variability in systolic dipping was greater in subjects with higher awake BP, but was not related to age, gender, race, or body mass index. Within individuals, day-to-day variations in dipping were related to variations in the fragmentation index (P < .001), a measure of sleep quality. Although mean 24-hour and awake BPs were relatively stable over repeated monitoring days, our study confirms substantial variability in BP dipping. Day-to-day differences in dipping are related to sleep quality.

Full Text

Duke Authors

Cited Authors

  • Hinderliter, AL; Routledge, FS; Blumenthal, JA; Koch, G; Hussey, MA; Wohlgemuth, WK; Sherwood, A

Published Date

  • November 2013

Published In

Volume / Issue

  • 7 / 6

Start / End Page

  • 432 - 439

PubMed ID

  • 23850195

Pubmed Central ID

  • PMC3865136

Electronic International Standard Serial Number (EISSN)

  • 1878-7436

Digital Object Identifier (DOI)

  • 10.1016/j.jash.2013.06.001


  • eng

Conference Location

  • United States