title: Blood pressure circadian pattern and physical exercise assessment by accelerometer and 7-day physical activity recall scale.
abstract: 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.
  
  
  BACKGROUND
  Clinical Trials.gov Identifier: NCT01083082.
authors: Alamedilla Health Center, Castilla y León Health Service (SACYL), Instituto de Investigación Biosanitario de Salamanca (IBSAL), Salamanca, Spain.
authors: Luis
authors: L
authors: García-Ortiz
authors: José I
authors: JI
authors: Recio-Rodríguez
authors: Anna
authors: A
authors: Puig-Ribera
authors: Jorge
authors: J
authors: Lema-Bartolomé
authors: Elisa
authors: E
authors: Ibáñez-Jalón
authors: Natividad
authors: N
authors: González-Viejo
authors: Nahia
authors: N
authors: Guenaga-Saenz
authors: Cristina
authors: C
authors: Agudo-Conde
authors: Maria C
authors: MC
authors: Patino-Alonso
authors: Manuel A
authors: MA
authors: Gomez-Marcos
mesh_terms: D056044:Actigraphy; D000204:Activity Cycles; D000328:Adult; D000368:Aged; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D016009:Chi-Square Distribution; D002940:Circadian Rhythm; D003430:Cross-Sectional Studies; D015444:Exercise; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D009043:Motor Activity; D016017:Odds Ratio; D013030:Spain; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: ambulatory blood pressure monitoring; blood pressure; circadian rhythm; dipping; hypertension; physical exercise.