title: Ambulatory pulse pressure is a relatively sleep-independent variable.
abstract: OBJECTIVE
  Characterization of sleep-induced pulse and mean arterial pressure (MAP) dip.
  
  
  METHODS
  Prospective study of consecutive referred patients.
  
  
  METHODS
  Hypertension unit of community university hospital.
  
  
  METHODS
  A total of 500 consecutive subjects referred to our unit for ambulatory blood pressure (BP) monitoring. There were 200 men and 300 women, the majority of which were treated hypertensives. Mean age was 59.7 +/- 16.6 years.
  
  
  METHODS
  Effect of sleep on MAP and pulse pressure (PP).
  
  
  RESULTS
  Twenty-four hour MAP was 98 +/- 10 mmHg. Awake and asleep MAPs were 101 +/- 11 and 87 +/- 11 mmHg, respectively. Twenty-four hour, awake and asleep pulse pressures were 60 +/- 13, 61 +/- 13 and 58 +/- 13 mmHg, respectively. MAP dip was 14%, 95% confidence interval (CI) 13.4-14.6, whereas PP dip was 5%, 95% CI 4.1-5.8. Thus, the MAP dip was almost three times the PP dip (P < 0.0001). This held true for normotensives, hypertensives (treated and untreated), men, women and diabetic subjects.
  
  
  CONCLUSIONS
  Although pulse pressure is derived from BP, it is more stable during a 24-h period, with a lesser effect of sleep compared with MAP. This more rigid nature of the PP could explain its better prognostic value, compared to that of MAP.
authors.affiliation: Hypertension Unit, Department of Medicine, Hadassah University Hospital, Mount Scopus, Jerusalem, Israel.
authors.forename: Gila
authors.initials: G
authors.lastname: Perk
authors.forename: Judith
authors.initials: J
authors.lastname: Mekler
authors.forename: Michael
authors.initials: M
authors.lastname: Bursztyn
mesh_terms: D000328:Adult; D000368:Aged; D001011:Aorta / Q000503:physiopathology; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D002940:Circadian Rhythm; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012890:Sleep