Nonlinear relation of the circadian blood pressure amplitude to cardiovascular disease risk

Germaine G Cornelissen-Guillaume, K. Otsuka, CH H. Chen, Y. Kumagai, Y. Watanabe, F. Halberg, J. Siegelova, J. Dusek

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Data from two independent studies are reanalyzed to determine how the MESOR and the circadian amplitude (A) of blood pressure (BP) as well as the 24-hour standard deviation (SD) of heart rate (HR) relate to vascular disease risk. In one prospective study, risk is quantified by the actual number of events that occurred within 6 years. In the other retrospective study, the left ventricular mass index (LVMI) was used as a surrogate outcome measure available for all subjects. The BP MESOR is found to be linearly related to risk. By contrast, the circadian BP-A and the 24-hour SD of HR show a nonlinear relation with risk, which is elevated only after a threshold value for BP-A or HR-SD is exceeded. For the diagnosis of a deviation in BP and HR, the recommendation to monitor for 7 days at the outset seems as reliable an assessment as practical, but it may not be sufficient, and the patient must be advised that further monitoring may be needed.

Original languageEnglish (US)
Pages (from-to)87-96
Number of pages10
JournalScripta Medica Facultatis Medicae Universitatis Brunensis Masarykianae
Issue number2
StatePublished - 2000


  • Cardiovascular disease risk
  • Circadian blood pressure amplitude
  • Essential hypertension


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