Aim of study: To study the BP levels and diurnal pattern on 24 hrs ambulatory monitoring in normotensive individuals from our population.

Material and Methods:  90 normotensive  individuals  of  either  sex  with  BP persistently < 140/90 mmHg (DBP—Korotkoff Phase V) not taking any antihypertensive medication were studied. All cases were subjected to 24 hr ambulatory blood pressure monitoring.

Results: The mean nighttime SBP and DBP were significantly lower than the mean daytime SBP and DBP. The mean nocturnal fall in SBP and DBP was -8.8±5.27 and 7.9±3.49 mm Hg respectively. In 94% nocturnal dipping was observed. Nocturnal dipping was less in persons aged > 40 years. No significant difference in nocturnal dipping between males and females was observed.

Conclusion: The 24 hour BP profile in our cases was similar to the western population. It seems that the criteria for elevated BP on ABPM adopted in the present guidelines are suitable for our population. Twenty-four hour ambulatory BP monitoring was well tolerated by our cases and there was no major problem.

Keywords: Blood pressure,  ambulatory  monitoring.

1. Ernest ME, Bergus GR: Noninvasive 24 hour Ambulatory Blood Pressure Monitoring: Overview of Technology and Clinical Applications. Pharmacotherapy 2002; 22(5).597-612.
2. Mancia G, SegaR, Bravi C et al: Ambulatory blood pressure normality: Results from the PAMELA Study. J. Hypertens 1995; 13:1377-1390.
3. Staessen JA, O’Brien ET, Atkins N, Amery AK. Ambulatory Blood pressure in normotensive compared with hypertensive subjects. J.Hypertens1993; 11: 1289-1297.
4. Zhang W, Shi H, Wang R et at. Reference values of the   ambulatory   blood   pressure:   results from collaborative study. Chin J Cardiol.1995;10: 325-328.
5. Kikuya M, Hansen TW, Thijs L, et al. Diagnostic thresholds for ambulatory blood pressure monitoring based on 10-year cardiovascular risk. Circulation.2007; 115:2145–52.
6. Whelton etal.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. Journal of American College of Cardiology.2018; 71:e127.
7. Hyman DJ, Ogbonnaya K, Taylor AA, HoK. Pavli L VN. Ethnic differences in nocturnal blood pressure decline in treated hypertensives. AmIHypertens 2000; 13(8).854-91.
8. Brien EO, Beavers G, Lip GYH: Blood pressure measurement- Part III —Automated sphygmomanometry: ambulatory blood pressure measurement. BMI 2001; 322.1110-14.
9. Ohkubo T. Imai Y, Tsuji I etaI : Relation between nocturnal decline in blood pressure and mortality. The Ohasama Am J Hyper tens1997;10(11): 1201-7
10. Pierdomenico SD, Bucci A, Costantini F, Lapenna D, Cuccurullo Mezzetti A. Circadianblood pressure changes and myocardial lischaemia in hypertensive patients with coronary artery disease. J Am Coll Cardiol 1998; 31(7):1627-34.
11. Verdecchia P, Schillaci G, Borgioni C et al. Gender day night blood pressure changes, and left ventricular mass in essential hypertension. Dippers and peakers. Am J Hypertens 1995; 8(2):193-6.
12. Staessen JA, Bieniaszewski L, O’Brien E et al. Nocturnal Blood pressure on Ambulatory Monitoring in a large International database the Ad –Hoc working group. Hypertension 1997; 29:30-9.
13. Manning G, Rushton L, Millar Craig MW. 24 hour ambulatory blood pressure; a sample from a normal British population. J Hum Hypertens. 1998; 12(2):123-7.
14. Weinberg N, Hoegholm A, Christensen HR et al. 24 hour ambulatory blood pressure in 352 normal Danish subjects related to age and gender. Am J Hypertens 1995; 8 (10 pt 1):986-87.
15. Staessen J, Bulpitt CJ, O’Brien E, Cox J et al. The diurnal blood pressure profile: a population study. Am J. Hypertens 1992; 5:386-392.

Vikas Agrawal

IMS, BHU, India