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| Circadian BP patterns tied to stroke risk |
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15 February 2006
A reduced nocturnal decline in BP appears to be associated with increased cerebral infarction risk and a large diurnal BP increase is tied to a greater risk of cerebral haemorrhage, Japanese researchers report in the February issue of Hypertension. Dr Takayoshi Ohkubo from the Tohoku University Graduate School of Pharmaceutical Science said that a lot of studies have shown that average values of 24-hour ambulatory blood pressure better predict the risk of cardiovascular disease including stroke than conventional blood pressure values. "Now," he said, "24-hour ambulatory blood pressure monitoring makes it possible to identify future risks of stroke subtypes separately by considering circadian patterns."
The investigators conducted an observational study of 1430 subjects ages 40 years or older who were taking part in a BP measurement project. They were followed for an average of 10.4 years. There were 128 cases of first stroke during this period. Of these, most (67%) were cerebral infarctions and 21% were intracerebral haemorrhages. There was no significant association between total stroke risk and the nocturnal decline in BP or with morning pressor surge. However, the cerebral infarction risk was significantly higher in subjects who had less than a 10% nocturnal decline in BP compared with those who had a greater decline. Participants with a morning pressor surge of 25 mmHg or greater were at increased risk of cerebral haemorrhage. This was also true of those with a 20% or greater nocturnal decline in BP.
Dr Ohkubo added that "further use of 24-hour ambulatory blood pressure monitoring would lead to more precise prediction of individual risks of subtypes of cardiovascular diseases."
Reference:
Hypertension 2006; 47 (2): 149-154.
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