Blood Pressure Circadian Pattern and Physical Exercise Assessment by Accelerometer and 7-Day Physical Activity Recall Scale

• Published in: American journal of hypertension Vol. 27; no. 5; pp. 665 - 673
• Main Authors: García-Ortiz, Luis, Recio-Rodríguez, José I, Puig-Ribera, Anna, Lema-Bartolomé, Jorge, Ibáñez-Jalón, Elisa, González-Viejo, Natividad, Guenaga-Saenz, Nahia, Agudo-Conde, Cristina, Patino-Alonso, Maria C., Gomez-Marcos, Manuel A.
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 01-05-2014
• Subjects: Actigraphy; Activity Cycles; Adult; Aged; Blood Pressure; Blood Pressure Monitoring, Ambulatory; Chi-Square Distribution; Circadian Rhythm; Confidence intervals; Cross-Sectional Studies; Drug therapy; Exercise; Female; Humans; Logistic Models; Male; Mental Recall; Middle Aged; Motor Activity; Odds Ratio; Spain; Surveys and Questionnaires; Time Factors; Spain; ambulatory blood pressure monitoring; blood pressure; physical exercise; hypertension; circadian rhythm; dipping
• ISSN: 0895-7061; 1941-7225
• DOI: 10.1093/ajh/hpt159

BACKGROUND
The relationship between regular physical activity, measured objectively and by self-report, and the circadian pattern of 24-hour ambulatory arterial blood pressure (BP) has not been clarified.
METHODS
We performed a cross-sectional study in a cohort of healthy patients. We included 1,345 patients from the EVIDENT study (mean age 55±14 years; 59.3% women). Physical activity was assessed using the 7-day physical activity recall (PAR) questionnaire (metabolic equivalents (MET)/hour/week) and the Actigraph GT3X accelerometer (counts/minute) for 7 days; ambulatory arterial BP was measured with a radial tonometer (B-pro device).
RESULTS
The dipper-pattern patients showed a higher level of activity than nondipper patients, as assessed by accelerometer and 7-day PAR. Physical activity measures correlated positively with the percent drop in systolic BP (SBP; ρ = 0.19 to 0.11; P < 0.01) and negatively with the systolic and diastolic sleep to wake ratios (ρ = −0.10 to −0.18; P < 0.01) and heart rate (ρ = −0.13; P < 0.01). In logistic regression, considering the circadian pattern (1, dipper; 0, nondipper) as the dependent variable, the odds ratio of the third tertile of counts/minute was 1.79 (95% confidence interval [CI], 1.35-2.38; P < 0.01) and of MET/hour/week was 1.33 (95% CI, 1.01-1.75; P = 0.04) after adjustment for confounding variables.
CONCLUSIONS
Physical activity, as evaluated by both the accelerometer and the 7-day PAR, was associated with a more marked nocturnal BP dip and, accordingly, a lower SBP and diastolic BP sleep to wake ratio.
CLINICAL TRIAL REGISTRATION
Clinical Trials.gov Identifier: NCT01083082