血压日变化和季变化规律（不分民族、性别）

Blood PressureVaries by Hour of Dayand Time of Year

Bruce Goldfarb

The odds of measuringan elevatedbloodpressurecan vary byas muchas 40% depending on the hour of the dayand the timeof year,according to researchersat Emory University's RollinsSchool of Public HealthinAtlanta, Ga.,and Danville, Penn.–basedGeisinger Health System.

Theinvestigators mined datafrom more than 2 million patientencountersat 57 Geisinger community practice clinics for the3–7 years for which electronic records wereavailable.Arandom sample of 203,927bloodpressuremeasurements from24,904 patients wasanalyzed for the study, which was presentedat theAmerican Society of Hypertension (ASH)annual meeting,held May 14–18inSan Francisco.

The odds of measuring systolicbloodpressure140 mmHgare lowest duringthe morningand middayand greatestinthe evening (see graph).Bloodpressureis up to 26% more likely to be elevatedat theend of the day thanat midday,according to CynthiaThomas,DO, MPH, of Geisinger's Center for Health Researchand RuralAdvocacy. Researchers found the likelihood of measuringasystolicpressure140 mmHg highest during the winter monthsand lowest duringthe summer (see graph). The results remained consistent regardlessof ethnicity,age, sex, history of hypertension, or treatmentstatus,according to researchers.

When temporal factorsare combined,bloodpressurecan varybyas muchas 40%. "We were surprised that the differences wereso large," Thomas says. "Inactual clinical practice, thereis real impact of these factors when considered together."

Odds of measuringasystolicbloodpressure140 mmHg by time of dayand month.

Variationinbloodpressureis widely recognized. But the degreeof dailyandseasonal swings was not previously known,and theclinical impact remainsindispute. Thomasand colleagues recommendthat cliniciansanticipate dailyandseasonal variabilityinbloodpressurewhen diagnosingand considering treatment optionsfor their patients.

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