title: Blood pressure outcomes of dental patients screened chronobiologically: a seven-year follow-up.
abstract: BACKGROUND
  This article is a follow-up on a 1998 article in JADA. The blood pressure, or BP, of 23 of 24 normotensive patients was monitored at 15-minute intervals for a total of nine days, in three consecutive sessions of four, two and three days, respectively, separated by a few weeks.
  
  
  METHODS
  Twelve patients were reached by phone seven years after the prior chronobiologically interpreted monitoring to ascertain their cardiovascular status since the initial monitoring.
  
  
  RESULTS
  Only two of the 12 patients reached in follow-up had abnormalities in all three sessions, and only these two patients reported having experienced an adverse vascular event (one a myocardial infarction, the other coronary artery bypass graft surgery). The difference in outcome between the patients with chronobiological abnormality in all three sessions vs. the pool of those with abnormality in only two, one or none of the sessions is statistically significant.
  
  
  CONCLUSIONS
  Even a five-day (and sometimes a longer) profile, while greatly preferred to single measurements, may not suffice for a definitive diagnosis of certain patients. Retrospectively, the 864 measurements, on the average, on each person in our study could have served for a recommendation to each person. Chronobiologically interpreted BP and heart rate monitoring for a week or longer as a start detects high-risk states that may be missed by conventional casual measurements that are rarely accompanied by one-day profiles.
  
  
  CONCLUSIONS
  The dentist has an important opportunity for conveying the importance of monitoring BP and heart rate for a week to detect an abnormal variability, and for implementing this monitoring. Dentists can educate patients regarding the need for screening and for interpreting the results for variability, and contribute to their overall health by referring them to their physicians when treatment is indicated.
authors.affiliation: University of Minnesota, School of Medicine, Department of Preventive Sciences, Minneapolis 55455, USA.
authors.forename: E M
authors.initials: EM
authors.lastname: Schaffer
authors.forename: G
authors.initials: G
authors.lastname: Cornélissen
authors.forename: N
authors.initials: N
authors.lastname: Rhodus
authors.forename: M
authors.initials: M
authors.lastname: Halhuber
authors.forename: Y
authors.initials: Y
authors.lastname: Watanabe
authors.forename: F
authors.initials: F
authors.lastname: Halberg
mesh_terms: D000367:Age Factors; D001794:Blood Pressure / Q000502:physiology*; D015924:Blood Pressure Monitors; D016022:Case-Control Studies; D002909:Chronobiology Phenomena; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000175:diagnosis; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000175:diagnosis; D016018:Least-Squares Analysis; D008297:Male; D008403:Mass Screening; D008991:Monitoring, Physiologic; D009203:Myocardial Infarction / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors