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(Hypertension. 2004;44:311.)
© 2004 American Heart Association, Inc.

Scientific Contributions

Disruption of Ultradian and Circadian Rhythms of Blood Pressure in Nondipper Hypertensive Patients

Santiago Perez-Lloret; Alejandro García Aguirre; Daniel P. Cardinali; Jorge E. Toblli

From the Department of Physiology (S.P.L., D.P.C.), Faculty of Medicine, University of Buenos Aires, Argentina, and Hypertension Section (A.G.A., J.E.T.), Hospital Alemán, Buenos Aires, Argentina.

Correspondence to Jorge E. Toblli, MD, PhD, Hypertension Section, Hospital Alemán Av Pueyrredón 1640, Buenos Aires 1118, Argentina. E-mail jtoblli{at}hospitalaleman.com

Ultradian rhythms in blood pressure (BP) are known to exist, but their modification in hypertension is largely unknown. The present study was undertaken to assess the integrity of ultradian and 24-hour BP rhythms in dipper (n=100) and nondipper (n=20) hypertensive patients compared with 44 dipper normotensive individuals. Fourier analysis was used to fit ultradian (12, 8, and 6 hour) and 24-hour rhythms in BP and heart rate (HR). Mesor, amplitude, and acrophase were calculated for individual and overall rhythm curves. All subjects showed significant ultradian or 24-hour BP and HR rhythms. Systolic and diastolic BP mesor was higher in hypertensive patients compared with normotensive patients. The percentage of variability in ambulatory BP that could be explained by fitting ultradian and 24-hour rhythms was reduced in nondippers compared with normotensives or dippers. Amplitude of ultradian and 24-hour rhythms in BP increased in dippers and decreased in nondippers. Ultradian and 24-hour rhythms in HR did not differ among the 3 groups examined. Results indicate that in nondippers, blunted ultradian and 24-hour rhythm amplitude in BP was accompanied by a loss of rhythm integrity.

Key Words: blood pressure monitoring, ambulatory • human • hypertension, arterial • circadian rhythm

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