Effects of an acute exposure to discotheque music on ambulatory blood pressure monitoring in normotensive subjects

98A

AIH-APRIL 1996-VOL. 9, NO.4, PART 2

ASH XI ABSTRAcrS

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THE DIURNAL VARIATION OF BLOOD PRESSURE IS PREDOMINANTLY DUE TO BEHAVIORAL FACTORS. JE Schwartz. KWarren and TG Pickering'. SUNY· Stony Brook and Cornell University Medical College, New York. There has been much debate over whether the pattern of blood pressures observed over 24 hours is predominantly due to behavioraUenvironmental factors or to an Internal biological rhythm. We have analyzed the ambulatory blood pressure (AmBP) recordings of 315 participants in the Cornell Work Site BP Study. Each subject wore a SpaceLabs 90207 AmBP monitor the! was programmed to take readings every 15-mlnute during waking hours and hourty during sleep. Using a "mixed level" linear model that allows for the serial autocorrelation of consecutive BP assessments, we estimated the pooled within-person diurnal pattern of AmBP, with a separete term for each hour of the day (DF=23): see solid curves In figures below. We then estimated the diurnal pattern while controlling for posture (standing, sitting or reclining) and location (at work, home, sleep, or othe,,: see dashed lines. While a mld-day peak and a post-midnight trough remain, clearly most of the diurnal variation can be accounted for by posture and location. In fact, of the total variability (chi-square) of systolic AmBP associated with 'hour of day', only 4% cannot be accounted for by posture and location; the figure Is 5% for diastolic AmBP. Given that posture and location have larger independent effects, we conclude that the diurnal pattern of BP is largely determined by the pattern of activity and arousal.

EFFECTS OF AN ACUTE SLEEP DEPRIVATION ON AMBULATORY BLOOD PRESSURE MONITORING IN HYPERTENSIVE PATIENTS. P Lusardi·. P Preti, A Zoppi*. L Corradi·. A Mugellini. S Savino and R Fogari·. Department of Internal Medicine and Therapeutics University of Pavia - Pavia, Italy. Aim: To evaluate the influence of an acute sleep deprivation during the first part of the night on blood pressure (BP) and heart rate (HR) in hypertensive subjects. Methods: Twelve never treated mild to moderate hypertensive palients aged 48-60 yr underwent 2 ABPM (Spacelabs 90207, start at I p.m. and measurements every IS min) one week from each other. During the first one. they slept from II p.m. to 7 a.m. while during the second one they slept from 2:30 a.m. to 7 a.m. The main results are as follows:

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Dlumal Cycle or Dle.toIlc BP.

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DBP 1'1 2nd t p.m. - 11 p.m. 151.3 152.5 86.8 87.9 75.6 77.1 II p.m. - 2 a.m. 131.4 150.2* 79.9 91.5* 69.3 74.4* 2 a.m. - 7 a.m. 130.5 135.1 80.2 85.4 65.3 65.7 7 a.m. - I pm. 153.3 159.7* 89.3 90.5 74.9 78.2 * ~ p<0.05 Conclusions: During the sleep deprivation hours BP didn't show any fall; during the sleep BP and HR showed no difference between the 2 ABPM. After awakening SBP was significantly higher in sleep deprivated subjects: it suggests that an acute sleep deprivation could be a stressful event potentially dangerous for patients with cardiovascular diseases

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ambulatory BP, diurnal cycle, diurnal variation, behavioral factors, posture, location

KeyWords: Sleep. Blood Pressure, Hean Rate, ABPM.

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EFFECTS OF FLUNITRAZEPAM ON AMBULATORY BLOOD PRESSURE MONITORING IN HYPERTENSIVE SUBJECTS. P Lusardi·. P Preti. A Zoppi·. A Mugellini. RM Pesce, S Savino and R Fogari·. Department of Internal Medicine and Therapeutics - University of Pavia - Pavia (Italy). Aim: to evaluate the effects of the evening administration of FIunitrazepam I mg on blood pressure (BP) and heart rale (HR) in hypertensive patienlS. Methods: II never treated mild hypertensives aged 54-65 (5 M and 6 F) underwent 2 ABPM (Spacelabs 90207, start at 2 p.m. and measurement every IS min) one week from each other. In both cases they slept from II p.m. to 7 a.m.: the first time they took a placebo tablet (P) at 10:30 p.m. while the 2nd one they took FIunitrazepam (F) I mg p.o. at the same hour. Results: The main results were as fol1ows:

EFFECTS OF AN ACUTE EXPOSURE TO DISCOTHEQUE MUSIC ON AMBULATORY BLOOD PRESSURE MONITORING IN NORMOTENSIVE SUBJECTS. f..1JIslwIi*, P Preti, AZoppi*, S Savino, A Mugellini and R Fogari*. Department of Internal Medicine and Therapeulics - University of Pavia - Pavia (Italy). Aim: to evaluate the effect of an acute exposure 10 discoth~que music on blood pressure (BP) and heart rate (HR) in

SBP P F 2 p.m. - 11 p.m 150.1 150.2 11 p.m.- 7 a.m. 125.4 121.2' 7 a.m.· 2 p.m. 1S1.5 143.1'** P < 0,0\ * P < 0.05

DBP P F 87 89 74.3 74.2 89.6 84.8-

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normotensives.

Methods: Ten normolensive volunteers (5 M and 5 F) aged 20-30 yr, with normal hearing tested with audiometry, underwent two 6-hourABPM on Sunday one week apart (start at 2:00 p.m.. stop at 8:00 p.m.• measurements every IS min.) During Ihe first one they were requested to enter the same discoth~que at 3:00 p.m. and Slay there until 6:00 p.m. without dancing or drinking any coffee or alcoholic beverage and not to change Iheir smoking habit. The noise level. assessed by an audiometer, was 90-95 dB. Durmg Ihe second ABPM they were requested to stay at home. Resulls: The main resulls are as follows:

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Conclusions: our data show that. after evening administration of FIunitrazepam, nocturnal SBP is lower than after a placebo. while no difference in DBP and HR have been observed: during the following morning SBP and DBP were significantly lower, while HR showed no change. This suggests that the evening Flunitrazepam intake as a night-time ipnotic in hypertensives could have a favourable effect on BP. The lowering in BP observed on the following morning is to be considered in the diagnostic evaluation and it could potentially interfere with the therapeutic response.

KeyWords: Flunitrazepam. ambulatory blood pressure monitoring. hypertensives.

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•• P < 0,01 Conclusions: The acute exposure to discoth~que music Induces a sigAlficant mcrease of SBP and DBP only dunng the fU'Sl hour: during the following Iwo hours DBP retoums 10 normal levels while SBP shows a trend to lower under the eontrol values. On the opposite HR shows a very significant increase during all lhe period of music exposure which partially persists during the hour immedialely following the exit from the discoth~que. Our data suggest thai BP and HR responses to an acute exposure 10 discolh~ue music are mediated by different mech:tllisms. Key Words: DiscolhCque music. ABPM. normolensives. C. Control day; D •

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