Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Diurnal blood pressure changes

Abstract

The definition of diurnal blood pressure changes varies widely, which can be confusing. Short-term blood pressure variability during a 24-h period and the dipping status of diurnal blood pressure can be captured by ambulatory blood pressure monitoring, and these metrics are reported to have prognostic significance for cardiovascular complications. Morning blood pressure surge also indicates this risk, but its effect may be limited to populations with specific conditions. Meanwhile, the combined use of conventional office blood pressure and out-of-office blood pressure allows us to identify people with white-coat and masked hypertension. Current home devices can measure nocturnal blood pressure during sleep more conveniently than ambulatory monitoring; however, we should pay attention to blood pressure measurement conditions regardless of whether they are in a home, ambulatory, or office setting. The relatively poor reproducibility of diurnal blood pressure changes, including the nocturnal fall of blood pressure, is another underestimated issue to be addressed. Although information on diurnal blood pressure changes is expected to be used more effectively in the future, we should also keep in mind that blood pressure levels have remained central to the primary and secondary prevention of blood pressure-related cardiovascular diseases in clinical practice.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy article

Get time limited or full article access on ReadCube.

$32.00

All prices are NET prices.

Fig. 1
Fig. 2
Fig. 3

References

  1. Kikuya M, Hozawa A, Ohkubo T, Tsuji I, Michimata M, Matsubara M, Ota M, Nagai K, Araki T, Satoh H, Ito S, Hisamichi S, Imai Y. Prognostic significance of blood pressure and heart rate variabilities: the Ohasama study. Hypertension. 2000;36:901–6.

    Article  PubMed  CAS  Google Scholar 

  2. Hansen TW, Thijs L, Li Y, Boggia J, Kikuya M, Björklund-Bodegård K, Richart T, Ohkubo T, Jeppesen J, Torp-Pedersen C, Dolan E, Kuznetsova T, Stolarz-Skrzypek K, Tikhonoff V, Malyutina S, Casiglia E, Nikitin Y, Lind L, Sandoya E, Kawecka-Jaszcz K, Imai Y, Wang J, Ibsen H, O’Brien E, Staessen JA. Prognostic value of reading-to-reading blood pressure variability over 24 h in 8938 subjects from 11 populations. Hypertension. 2010;55:1049–57.

    Article  PubMed  CAS  Google Scholar 

  3. Kario K, Pickering TG, Umeda Y, Hoshide S, Hoshide Y, Morinari M, Murata M, Kuroda T, Schwartz JE, Shimada K. Morning surge in blood pressure as a predictor of silent and clinical cerebrovascular disease in elderly hypertensives: a prospective study. Circulation. 2003;107:1401–6.

    Article  PubMed  Google Scholar 

  4. Asayama K, Ohkubo T, Metoki H, Obara T, Inoue R, Kikuya M, Thijs L, Staessen JA, Imai Y. Cardiovascular outcomes in the first trial of antihypertensive therapy guided by self-measured home blood pressure. Hypertens Res. 2012;35:1102–10.

    Article  PubMed  Google Scholar 

  5. Chonan K, Kikuya M, Araki T, Fujiwara T, Suzuki M, Michimata M, Hashimoto J, Ohkubo T, Hozawa A, Yamamoto N, Miyawaki Y, Matsubara M, Imai Y. Device for the self-measurement of blood pressure that can monitor blood pressure during sleep. Blood Press Monit. 2001;6:203–5.

    Article  PubMed  CAS  Google Scholar 

  6. Ishikawa J, Hoshide S, Eguchi K, Ishikawa S, Shimada K, Kario K, Japan Morning Surge-Home Blood Pressure Study Investigators G. Nighttime home blood pressure and the risk of hypertensive target organ damage. Hypertension. 2012;60:921–8.

    Article  PubMed  CAS  Google Scholar 

  7. Kollias A, Ntineri A, Stergiou GS. Association of night-time home blood pressure with night-time ambulatory blood pressure and target-organ damage: a systematic review and meta-analysis. J Hypertens. 2017;35:442–52.

    Article  PubMed  CAS  Google Scholar 

  8. Asayama K, Thijs L, Brguljan-Hitij J, Niiranen TJ, Hozawa A, Boggia J, Aparicio LS, Hara A, Johansson JK, Ohkubo T, Tzourio C, Stergiou GS, Sandoya E, Tsuji I, Jula AM, Imai Y, Staessen JA. International Database of Home Blood Pressure in Relation to Cardiovascular Outcome investigators. Risk stratification by self-measured home blood pressure across categories of conventional blood pressure: a participant-level meta-analysis. PLoS Med. 2014;11:e1001591.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Satoh M, Asayama K, Kikuya M, Inoue R, Metoki H, Hosaka M, Tsubota-Utsugi M, Obara T, Ishiguro A, Murakami K, Matsuda A, Yasui D, Murakami T, Mano N, Imai Y, Ohkubo T. Long-term stroke risk due to partial white-coat or masked hypertension based on home and ambulatory blood pressure measurements: the Ohasama study. Hypertension. 2016;67:48–55.

    Article  PubMed  CAS  Google Scholar 

  10. Mena L, Pintos S, Queipo NV, Aizpurua JA, Maestre G, Sulbaran T. A reliable index for the prognostic significance of blood pressure variability. J Hypertens. 2005;23:505–11.

    Article  PubMed  CAS  Google Scholar 

  11. Chowdhury EK, Wing LMH, Jennings GLR, Beilin LJ, Reid CM, Committee AM. Visit-to-visit (long-term) and ambulatory (short-term) blood pressure variability to predict mortality in an elderly hypertensive population. J Hypertens. 2017;36:1059–67. https://doi.org/10.1097/HJH.0000000000001652.

    Article  Google Scholar 

  12. Palatini P, Reboldi G, Beilin LJ, Casiglia E, Eguchi K, Imai Y, Kario K, Ohkubo T, Pierdomenico SD, Schwartz JE, Wing L, Verdecchia P. Added predictive value of night-time blood pressure variability for cardiovascular events and mortality: the ambulatory blood pressure-international study. Hypertension. 2014;64:487–93.

    Article  PubMed  CAS  Google Scholar 

  13. Pickering TG. The clinical significance of diurnal blood pressure variations. Dippers and nondippers. Circulation. 1990;81:700–2.

    Article  PubMed  CAS  Google Scholar 

  14. O’Brien E, Sheridan J, O’Malley K. Dippers and non-dippers. Lancet. 1988;2:397.

    Article  PubMed  Google Scholar 

  15. Shimamoto K, Ando K, Fujita T, Hasebe N, Higaki J, Horiuchi M, Imai Y, Imaizumi T, Ishimitsu T, Ito M, Ito S, Itoh H, Iwao H, Kai H, Kario K, Kashihara N, Kawano Y, Kim-Mitsuyama S, Kimura G, Kohara K, Komuro I, Kumagai H, Matsuura H, Miura K, Morishita R, Naruse M, Node K, Ohya Y, Rakugi H, Saito I, Saitoh S, Shimada K, Shimosawa T, Suzuki H, Tamura K, Tanahashi N, Tsuchihashi T, Uchiyama M, Ueda S, Umemura S. Japanese Society of Hypertension Committee for Guidelines for the Management of Hypertension. The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2014). Hypertens Res. 2014;37:253–390.

    Article  PubMed  CAS  Google Scholar 

  16. O’Brien E, Parati G, Stergiou G, Asmar R, Beilin L, Bilo G, Clement D, de la Sierra A, de Leeuw P, Dolan E, Fagard R, Graves J, Head GA, Imai Y, Kario K, Lurbe E, Mallion JM, Mancia G, Mengden T, Myers M, Ogedegbe G, Ohkubo T, Omboni S, Palatini P, Redon J, Ruilope LM, Shennan A, Staessen JA, vanMontfrans G, Verdecchia P, Waeber B, Wang J, Zanchetti A, Zhang Y, European Society of Hypertension Working Group on Blood Pressure M. European Society of Hypertension position paper on ambulatory blood pressure monitoring. J Hypertens. 2013;31:1731–68.

    Article  PubMed  CAS  Google Scholar 

  17. O’Brien E, Parati G, Stergiou G. Response to: nocturnal blood pressure dipping: systolic, diastolic or both? J Hypertens. 2014;32:700–1.

    Article  PubMed  CAS  Google Scholar 

  18. Imai Y, Abe K, Sasaki S, Minami N, Nihei M, Munakata M, Murakami O, Matsue K, Sekino H, Miura Y, Yoshinaga K. Altered circadian blood pressure rhythm in patients with Cushing’s syndrome. Hypertension. 1988;12:11–19.

    Article  PubMed  CAS  Google Scholar 

  19. Imai Y, Abe K, Sasaki S, Minami N, Munakata M, Nihei M, Sekino H, Yoshinaga K. Exogenous glucocorticoid eliminates or reverses circadian blood pressure variations. J Hypertens. 1989;7:113–20.

    PubMed  CAS  Google Scholar 

  20. Pecori Giraldi F, Toja PM, De Martin M, Maronati A, Scacchi M, Omboni S, Cavagnini F, Parati G. Circadian blood pressure profile in patients with active Cushing’s disease and after long-term cure. Horm Metab Res. 2007;39:908–14.

    Article  PubMed  CAS  Google Scholar 

  21. Nagai M, Hoshide S, Ishikawa J, Shimada K, Kario K. Insular cortex atrophy as an independent determinant of disrupted diurnal rhythm of ambulatory blood pressure in elderly hypertension. Am J Hypertens. 2009;22:723–9.

    Article  PubMed  Google Scholar 

  22. Grossman E, Laudon M, Zisapel N. Effect of melatonin on nocturnal blood pressure: meta-analysis of randomized controlled trials. Vasc Health Risk Manag. 2011;7:577–84.

    PubMed  PubMed Central  CAS  Google Scholar 

  23. Zeman M, Dulkova K, Bada V, Herichova I. Plasma melatonin concentrations in hypertensive patients with the dipping and non-dipping blood pressure profile. Life Sci. 2005;76:1795–803.

    Article  PubMed  CAS  Google Scholar 

  24. Boggia J, Li Y, Thijs L, Hansen TW, Kikuya M, Björklund-Bodegård K, Richart T, Ohkubo T, Kuznetsova T, Torp-Pedersen C, Lind L, Ibsen H, Imai Y, Wang J, Sandoya E, O’Brien E, Staessen JA. Prognostic accuracy of day versus night ambulatory blood pressure: a cohort study. Lancet. 2007;370:1219–29.

    Article  PubMed  Google Scholar 

  25. Kobrin I, Oigman W, Kumar A, Ventura HO, Messerli FH, Frohlich ED, Dunn FG. Diurnal variation of blood pressure in elderly patients with essential hypertension. J Am Geriatr Soc. 1984;32:896–9.

    Article  PubMed  CAS  Google Scholar 

  26. Cai A, Zhong Q, Liu C, Zhou D, Li X, Zhang Y, Feng Y, Zhou Y. Associations of systolic and diastolic blood pressure night-to-day ratios with atherosclerotic cardiovascular diseases. Hypertens Res. 2016;39:874–8.

    Article  PubMed  CAS  Google Scholar 

  27. Reeves RA, Shapiro AP, Thompson ME, Johnsen AM. Loss of nocturnal decline in blood pressure after cardiac transplantation. Circulation. 1986;73:401–8.

    Article  PubMed  CAS  Google Scholar 

  28. Nakai K, Fujii H, Watanabe K, Watanabe S, Awata R, Kono K, Yonekura Y, Goto S, Nishi S. Riser pattern is a predictor of kidney mortality among patients with chronic kidney disease. Clin Exp Hypertens. 2016;38:476–81.

    Article  PubMed  Google Scholar 

  29. Wang C, Zhang J, Liu X, Li C, Ye Z, Peng H, Chen Z, Lou T. Reversed dipper blood-pressure pattern is closely related to severe renal and cardiovascular damage in patients with chronic kidney disease. PLoS ONE. 2013;8:e55419.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  30. Azancot MA, Ramos N, Moreso FJ, Ibernon M, Espinel E, Torres IB, Fort J, Seron D. Hypertension in chronic kidney disease: the influence of renal transplantation. Transplantation. 2014;98:537–42.

    Article  PubMed  Google Scholar 

  31. Stergiou GS, Triantafyllidou E, Cholidou K, Kollias A, Destounis A, Nasothimiou EG, Markozannes E, Alchanatis M. Asleep home blood pressure monitoring in obstructive sleep apnea: a pilot study. Blood Press Monit. 2013;18:21–26.

    Article  PubMed  Google Scholar 

  32. Kario K. Obstructive sleep apnea syndrome and hypertension: ambulatory blood pressure. Hypertens Res. 2009;32:428–32.

    Article  PubMed  Google Scholar 

  33. Ohkubo T, Hozawa A, Yamaguchi J, Kikuya M, Ohmori K, Michimata M, Matsubara M, Hashimoto J, Hoshi H, Araki T, Tsuji I, Satoh H, Hisamichi S, Imai Y. Prognostic significance of the nocturnal decline in blood pressure in individuals with and without high 24-h blood pressure: the Ohasama study. J Hypertens. 2002;20:2183–9.

    Article  PubMed  CAS  Google Scholar 

  34. Satoh M, Asayama K, Kikuya M, Inoue R, Tsubota-Utsugi M, Obara T, Murakami K, Matsuda A, Murakami T, Nomura K, Metoki H, Imai Y, Ohkubo T. Nocturnal blood pressure decline based on different time intervals and long-term cardiovascular risk: the Ohasama Study. Clin Exp Hypertens. 2018;40:1–7.

    Article  PubMed  Google Scholar 

  35. Stolarz-Skrzypek K, Thijs L, Richart T, Li Y, Hansen TW, Boggia J, Kuznetsova T, Kikuya M, Kawecka-Jaszcz K, Staessen JA. Blood pressure variability in relation to outcome in the International Database of Ambulatory blood pressure in relation to Cardiovascular Outcome. Hypertens Res. 2010;33:757–66.

    Article  PubMed  Google Scholar 

  36. Asayama K, Wei FF, Hara A, Hansen TW, Li Y, Staessen JA. Prognosis in relation to blood pressure variability: con side of the argument. Hypertension. 2015;65:1170–9.

    Article  PubMed  CAS  Google Scholar 

  37. Muller JE, Stone PH, Turi ZG, Rutherford JD, Czeisler CA, Parker C, Poole WK, Passamani E, Roberts R, Robertson T, Sobel BE, Willerson JT, Braunwald E. The Multicenter Investigation of the Limitation of Infarct Size (MILIS) Study Group. Circadian variation in the frequency of onset of acute myocardial infarction. N Engl J Med. 1985;313:1315–22.

    Article  PubMed  CAS  Google Scholar 

  38. Metoki H, Ohkubo T, Kikuya M, Asayama K, Obara T, Hashimoto J, Totsune K, Hoshi H, Satoh H, Imai Y. Prognostic significance for stroke of a morning pressor surge and a nocturnal blood pressure decline: the Ohasama study. Hypertension. 2006;47:149–54.

    Article  PubMed  CAS  Google Scholar 

  39. Verdecchia P, Angeli F, Mazzotta G, Garofoli M, Ramundo E, Gentile G, Ambrosio G, Reboldi G. Day-night dip and early-morning surge in blood pressure in hypertension: prognostic implications. Hypertension. 2012;60:34–42.

    Article  PubMed  CAS  Google Scholar 

  40. Gosse P, Lasserre R, Minifie C, Lemetayer P, Clementy J. Blood pressure surge on rising. J Hypertens. 2004;22:1113–8.

    Article  PubMed  CAS  Google Scholar 

  41. Li Y, Thijs L, Hansen TW, Kikuya M, Boggia J, Richart T, Metoki H, Ohkubo T, Torp-Pedersen C, Kuznetsova T, Stolarz-Skrzypek K, Tikhonoff V, Malyutina S, Casiglia E, Nikitin Y, Sandoya E, Kawecka-Jaszcz K, Ibsen H, Imai Y, Wang J, Staessen JA. Prognostic value of the morning blood pressure surge in 5645 subjects from 8 populations. Hypertension. 2010;55:1040–8.

    Article  PubMed  CAS  Google Scholar 

  42. Bombelli M, Fodri D, Toso E, Macchiarulo M, Cairo M, Facchetti R, Dell’Oro R, Grassi G, Mancia G. Relationship among morning blood pressure surge, 24-hour blood pressure variability, and cardiovascular outcomes in a white population. Hypertension. 2014;64:943–50.

    Article  PubMed  CAS  Google Scholar 

  43. Asayama K, Ohkubo T, Kikuya M, Obara T, Metoki H, Inoue R, Hara A, Hirose T, Hoshi H, Hashimoto J, Totsune K, Satoh H, Imai Y. Prediction of stroke by home “morning” versus “evening” blood pressure values: the Ohasama study. Hypertension. 2006;48:737–43.

    Article  PubMed  CAS  Google Scholar 

  44. Kario K, Saito I, Kushiro T, Teramukai S, Ishikawa Y, Mori Y, Kobayashi F, Shimada K. Home blood pressure and cardiovascular outcomes in patients during antihypertensive therapy: primary results of HONEST, a large-scale prospective, real-world observational study. Hypertension. 2014;64:989–96.

    Article  PubMed  CAS  Google Scholar 

  45. Whelton PK, Carey RM, Aronow WS, Casey DE Jr., Collins KJ, Dennison Himmelfarb C, DePalma SM, Gidding S, Jamerson KA, Jones DW, MacLaughlin EJ, Muntner P, Ovbiagele B, Smith SC Jr., Spencer CC, Stafford RS, Taler SJ, Thomas RJ, Williams KA Sr., Williamson JD, Wright JT Jr.. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2017;71:1269–324. https://doi.org/10.1161/HYP.0000000000000065.

    Article  PubMed  CAS  Google Scholar 

  46. Kikuya M, Hansen TW, Thijs L, Björklund-Bodegård K, Kuznetsova T, Ohkubo T, Richart T, Torp-Pedersen C, Lind L, Ibsen H, Imai Y, Staessen JA. Diagnostic thresholds for ambulatory blood pressure monitoring based on 10-year cardiovascular risk. Circulation. 2007;115:2145–52.

    Article  PubMed  Google Scholar 

  47. Staessen JA, Wang JG, Thijs L. Cardiovascular protection and blood pressure reduction: a meta-analysis. Lancet. 2001;358:1305–15.

    Article  PubMed  CAS  Google Scholar 

  48. Franklin SS, Thijs L, Hansen TW, Li Y, Boggia J, Kikuya M, Bjorklund-Bodegard K, Ohkubo T, Jeppesen J, Torp-Pedersen C, Dolan E, Kuznetsova T, Stolarz-Skrzypek K, Tikhonoff V, Malyutina S, Casiglia E, Nikitin Y, Lind L, Sandoya E, Kawecka-Jaszcz K, Imai Y, Wang J, Ibsen H, O’Brien E, Staessen JA. Significance of white-coat hypertension in older persons with isolated systolic hypertension: a meta-analysis using the International Database on Ambulatory Blood Pressure Monitoring in Relation to Cardiovascular Outcomes population. Hypertension. 2012;59:564–71.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  49. Asayama K, Thijs L, Li Y, Gu YM, Hara A, Liu YP, Zhang Z, Wei FF, Lujambio I, Mena LJ, Boggia J, Hansen TW, Bjorklund-Bodegard K, Nomura K, Ohkubo T, Jeppesen J, Torp-Pedersen C, Dolan E, Stolarz-Skrzypek K, Malyutina S, Casiglia E, Nikitin Y, Lind L, Luzardo L, Kawecka-Jaszcz K, Sandoya E, Filipovsky J, Maestre GE, Wang J, Imai Y, Franklin SS, O’Brien E, Staessen JA, International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcomes Investigators. Setting thresholds to varying blood pressure monitoring intervals differentially affects risk estimates associated with white-coat and masked hypertension in the population. Hypertension. 2014;64:935–42.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  50. Ugajin T, Hozawa A, Ohkubo T, Asayama K, Kikuya M, Obara T, Metoki H, Hoshi H, Hashimoto J, Totsune K, Satoh H, Tsuji I, Imai Y. White-coat hypertension as a risk factor for the development of home hypertension: the Ohasama study. Arch Intern Med. 2005;165:1541–6.

    Article  PubMed  Google Scholar 

  51. Hansen TW, Kikuya M, Thijs L, Björklund-Bodegård K, Kuznetsova T, Ohkubo T, Richart T, Torp-Pedersen C, Lind L, Jeppesen J, Ibsen H, Imai Y, Staessen JA. Prognostic superiority of daytime ambulatory over conventional blood pressure in four populations: a meta-analysis of 7030 individuals. J Hypertens. 2007;25:1554–64.

    Article  PubMed  CAS  Google Scholar 

  52. Brguljan-Hitij J, Thijs L, Li Y, Hansen TW, Boggia J, Liu YP, Asayama K, Wei FF, Bjorklund-Bodegard K, Gu YM, Ohkubo T, Jeppesen J, Torp-Pedersen C, Dolan E, Kuznetsova T, Katarzyna SS, Tikhonoff V, Malyutina S, Casiglia E, Nikitin Y, Lind L, Sandoya E, Kawecka-Jaszcz K, Filipovsky J, Imai Y, Wang J, O’Brien E, Staessen JA. International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcome Investigators. Risk stratification by ambulatory blood pressure monitoring across JNC classes of conventional blood pressure. Am J Hypertens. 2014;27:956–65.

    Article  PubMed  Google Scholar 

  53. Franklin SS, O’Brien E, Staessen JA. Masked hypertension: understanding its complexity. Eur Heart J. 2017;38:1112–8.

    PubMed  Google Scholar 

  54. Franklin SS, Thijs L, Li Y, Hansen TW, Boggia J, Liu Y, Asayama K, Bjorklund-Bodegard K, Ohkubo T, Jeppesen J, Torp-Pedersen C, Dolan E, Kuznetsova T, Stolarz-Skrzypek K, Tikhonoff V, Malyutina S, Casiglia E, Nikitin Y, Lind L, Sandoya E, Kawecka-Jaszcz K, Filipovsky J, Imai Y, Wang J, Ibsen H, O’Brien E, Staessen JA. International Database on Ambulatory blood pressure in Relation to Cardiovascular Outcomes Investigators. Masked hypertension in diabetes mellitus: treatment implications for clinical practice. Hypertension. 2013;61:964–71.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  55. Asayama K, Li Y, Franklin SS, Thijs L, O’Brien E, Staessen JA. Cardiovascular risk associated with white-coat hypertension: con side of the argument. Hypertension. 2017;70:676–82.

    Article  PubMed  CAS  Google Scholar 

  56. Mancia G, Bombelli M, Cuspidi C, Facchetti R, Grassi G. Cardiovascular risk associated with white-coat hypertension: pro side of the argument. Hypertension. 2017;70:668–75.

    Article  PubMed  CAS  Google Scholar 

  57. Huang Y, Huang W, Hu Y. Is white-coat hypertension associated with risk of cardiovascular diseases? J Am Coll Cardiol. 2017;69:2880.

    Article  PubMed  Google Scholar 

  58. Franklin SS, Thijs L, Staessen JA. Reply: is white-coat hypertension associated with risk of cardiovascular diseases? J Am Coll Cardiol. 2017;69:2880–1.

    Article  PubMed  Google Scholar 

  59. Mancia G, Grassi G. The heterogeneous nature of white-coat hypertension. J Am Coll Cardiol. 2016;68:2044–6.

    Article  PubMed  Google Scholar 

  60. Conen D, Aeschbacher S, Thijs L, Li Y, Boggia J, Asayama K, Hansen TW, Kikuya M, Bjorklund-Bodegard K, Ohkubo T, Jeppesen J, Gu YM, Torp-Pedersen C, Dolan E, Kuznetsova T, Stolarz-Skrzypek K, Tikhonoff V, Schoen T, Malyutina S, Casiglia E, Nikitin Y, Lind L, Sandoya E, Kawecka-Jaszcz K, Mena L, Maestre GE, Filipovsky J, Imai Y, O’Brien E, Wang JG, Risch L, Staessen JA. Age-specific differences between conventional and ambulatory daytime blood pressure values. Hypertension. 2014;64:1073–9.

    Article  PubMed  CAS  Google Scholar 

  61. Huang Y, Huang W, Mai W, Cai X, An D, Liu Z, Huang H, Zeng J, Hu Y, Xu D. White-coat hypertension is a risk factor for cardiovascular diseases and total mortality. J Hypertens. 2017;35:677–88.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  62. Imai Y, Kario K, Shimada K, Kawano Y, Hasebe N, Matsuura H, Tsuchihashi T, Ohkubo T, Kuwajima I, Miyakawa M. The Japanese Society of Hypertension guidelines for self-monitoring of blood pressure at home (second edition). Hypertens Res. 2012;35:777–95.

    Article  PubMed  Google Scholar 

  63. Andreadis EA, Agaliotis G, Kollias A, Kolyvas G, Achimastos A, Stergiou GS. Night-time home versus ambulatory blood pressure in determining target organ damage. J Hypertens. 2016;34:438–44.

    Article  PubMed  CAS  Google Scholar 

  64. Lindroos AS, Johansson JK, Puukka PJ, Kantola I, Salomaa V, Juhanoja EP, Siven SS, Jousilahti P, Jula AM, Niiranen TJ. The association between home vs. ambulatory night-time blood pressure and end-organ damage in the general population. J Hypertens. 2016;34:1730–7.

    Article  PubMed  CAS  Google Scholar 

  65. Hermida RC, Ayala DE, Smolensky MH, Fernandez JR, Mojon A, Portaluppi F. Chronotherapy with conventional blood pressure medications improves management of hypertension and reduces cardiovascular and stroke risks. Hypertens Res. 2016;39:277–92.

    Article  PubMed  CAS  Google Scholar 

  66. Head GA. The importance and prognostic value of nocturnal blood pressure assessments using inexpensive domestic devices. J Hypertens. 2017;35:463–5.

    Article  PubMed  CAS  Google Scholar 

  67. Sheng CS, Cheng YB, Wei FF, Yang WY, Guo QH, Li FK, Huang QF, Thijs L, Staessen JA, Wang JG, Li Y. Diurnal blood pressure rhythmicity in relation to environmental and genetic cues in untreated referred patients. Hypertension. 2017;69:128–35.

    Article  PubMed  CAS  Google Scholar 

  68. Omboni S, Parati G, Palatini P, Vanasia A, Muiesan ML, Cuspidi C, Mancia G. Reproducibility and clinical value of nocturnal hypotension: prospective evidence from the SAMPLE study. Study on ambulatory monitoring of pressure and lisinopril evaluation. J Hypertens. 1998;16:733–8.

    Article  PubMed  CAS  Google Scholar 

  69. Thijs L, Amery A, Clement D, Cox J, de Cort P, Fagard R, Fowler G, Guo C, Mancia G, Marin R, O’Brien E, O’Malley K, Palatini P, Parati G, Petrie J, Ravogli A, Rosenfeld J, Staessen J, Webster J. Ambulatory blood pressure monitoring in elderly patients with isolated systolic hypertension. J Hypertens. 1992;10:693–9.

    Article  PubMed  CAS  Google Scholar 

  70. Hinderliter AL, Routledge FS, Blumenthal JA, Koch G, Hussey MA, Wohlgemuth WK, Sherwood A. Reproducibility of blood pressure dipping: relation to day-to-day variability in sleep quality. J Am Soc Hypertens. 2013;7:432–9.

    Article  PubMed  Google Scholar 

  71. Palatini P, Mormino P, Canali C, Santonastaso M, De Venuto G, Zanata G, Pessina AC. Factors affecting ambulatory blood pressure reproducibility. Results of the HARVEST Trial. Hypertension and Ambulatory Recording Venetia Study. Hypertension. 1994;23:211–6.

    Article  PubMed  CAS  Google Scholar 

  72. Mochizuki Y, Okutani M, Donfeng Y, Iwasaki H, Takusagawa M, Kohno I, Mochizuki S, Umetani K, Ishii H, Ijiri H, Komori S, Tamura K. Limited reproducibility of circadian variation in blood pressure dippers and nondippers. Am J Hypertens. 1998;11:403–9.

    Article  PubMed  CAS  Google Scholar 

  73. Hosohata K, Kikuya M, Ohkubo T, Metoki H, Asayama K, Inoue R, Obara T, Hashimoto J, Totsune K, Hoshi H, Satoh H, Imai Y. Reproducibility of nocturnal blood pressure assessed by self-measurement of blood pressure at home. Hypertens Res. 2007;30:707–12.

    Article  PubMed  Google Scholar 

  74. Scarpelli PT, Gallo M, Chiari G. Chronobiology of blood pressure. J Nephrol. 2000;13:197–204.

    PubMed  CAS  Google Scholar 

  75. Hermida RC, Ayala DE, Fernandez JR, Mojon A, Smolensky MH. Hypertension: new perspective on its definition and clinical management by bedtime therapy substantially reduces cardiovascular disease risk. Eur J Clin Invest. 2018;48:e12909 https://doi.org/10.1111/eci.12909.

    Article  PubMed  Google Scholar 

  76. Roush GC, Fapohunda J, Kostis JB. Evening dosing of antihypertensive therapy to reduce cardiovascular events: a third type of evidence based on a systematic review and meta-analysis of randomized trials. J Clin Hypertens (Greenwich). 2014;16:561–8.

    Article  CAS  Google Scholar 

  77. Hermida RC, Ayala DE, Mojon A, Fernandez JR. Decreasing sleep-time blood pressure determined by ambulatory monitoring reduces cardiovascular risk. J Am Coll Cardiol. 2011;58:1165–73.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

We acknowledge the Editorial Board of Hypertension Research for giving the authors the opportunity to publish this article.

Funding

KA received research support from Omron Healthcare.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kei Asayama.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Asayama, K., Satoh, M. & Kikuya, M. Diurnal blood pressure changes. Hypertens Res 41, 669–678 (2018). https://doi.org/10.1038/s41440-018-0054-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41440-018-0054-0

This article is cited by

Search

Quick links