title: The Diurnal Profile of Central Hemodynamics in a General Uruguayan Population.
abstract: No previous population study assessed the diurnal profile of central arterial properties.
  
  
  
  In 167 participants (mean age, 56.1 years; 63.5% women), randomly recruited in Montevideo, Uruguay, we used the oscillometric Mobil-O-Graph 24-h PWA monitor to measure peripheral and central systolic (SBP), diastolic (DBP), and pulse (PP) pressures and central hemodynamics standardized to a heart rate of 75 bpm, including aortic pulse wave velocity, systolic augmentation (first/second peak × 100), and pressure amplification (peripheral PP/central PP).
  
  
  
  Over 24 hours, day and night, peripheral minus central differences in SBP/DBP and in PP averaged 12.2/-1.1, 14.0/-0.7, and 9.7/0.2mm Hg and 12.6, 14.7, and 9.5mm Hg, respectively (P < 0.001 except for nighttime DBP (P = 0.38)). The central-to-peripheral ratios of SBP, DBP, and PP were 0.89, 1.00, and 0.70 unadjusted, but after accounting for anthropometric characteristics decreased to 0.74, 0.97, and 0.63, respectively, with strong influence of height for SBP and DBP and of sex for PP. From day (10-20h) to nighttime (0-6h), peripheral (-10.4/-10.5 mm Hg) and central (-6.0/-11.3mm Hg) SBP/DBP, pulse wave velocity (-0.7 m/s) and pressure amplification (-0.05) decreased (P < 0.001), whereas central PP (+5.3mm Hg) and systolic augmentation (+2.3%) increased (P < 0.001).
  
  
  
  The diurnal rhythm of central pressure runs in parallel with that of peripheral pressure, but the nocturnal fall in SBP is smaller centrally than peripherally. pulse wave velocity, systolic augmentation, and pressure amplification loop through the day with high pulse wave velocity and pressure amplification but low systolic augmentation in the evening and opposite trends in the morning.
authors.affiliation: Unidad de Hipertensión Arterial, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay; Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay; Centro de Nefrología, Universidad de la República, Montevideo, Uruguay; jboggia@hc.edu.uy.
authors.forename: José
authors.initials: J
authors.lastname: Boggia
authors.affiliation: Unidad de Hipertensión Arterial, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay; Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay; Centro de Nefrología, Universidad de la República, Montevideo, Uruguay;
authors.forename: Leonella
authors.initials: L
authors.lastname: Luzardo
authors.affiliation: Unidad de Hipertensión Arterial, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay; Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay;
authors.forename: Inés
authors.initials: I
authors.lastname: Lujambio
authors.affiliation: Unidad de Hipertensión Arterial, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay; Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay; Centro de Nefrología, Universidad de la República, Montevideo, Uruguay;
authors.forename: Mariana
authors.initials: M
authors.lastname: Sottolano
authors.affiliation: Unidad de Hipertensión Arterial, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay; Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay;
authors.forename: Sebastián
authors.initials: S
authors.lastname: Robaina
authors.affiliation: Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium;
authors.forename: Lutgarde
authors.initials: L
authors.lastname: Thijs
authors.affiliation: Departamento de Laboratorio Clínico, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay;
authors.forename: Alicia
authors.initials: A
authors.lastname: Olascoaga
authors.affiliation: Unidad de Hipertensión Arterial, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay; Centro de Nefrología, Universidad de la República, Montevideo, Uruguay;
authors.forename: Oscar
authors.initials: O
authors.lastname: Noboa
authors.affiliation: Department of Pharmacology, Maastricht University, Maastricht, The Netherlands;
authors.forename: Harry A
authors.initials: HA
authors.lastname: Struijker-Boudier
authors.affiliation: Faculty of Medicine, Hôtel-Dieu Hospital, Paris-Descartes University, Paris, France;
authors.forename: Michel E
authors.initials: ME
authors.lastname: Safar
authors.affiliation: Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium; R & D VitaK Group, Maastricht University, Maastricht, The Netherlands.
authors.forename: Jan A
authors.initials: JA
authors.lastname: Staessen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D002940:Circadian Rhythm; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D013599:Systole; D014583:Uruguay; D055815:Young Adult
keywords: aortic pulse wave velocity; arterial stiffness; blood pressure monitoring; central blood pressure; hypertension; population science.