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Circulation, Vol 68, 477-483, Copyright © 1983 by American Heart Association
S Mann, DG Altman, EB Raftery and R Bannister
We have monitored ambulant intra-arterial blood pressure with the Oxford
system in six subjects with autonomic failure who exhibited postural
hypotension. Plotting pooled hourly mean values we have demonstrated a
consistent circadian trend in blood pressure that was the inverse of the
normal pattern, with the highest pressures at night and the lowest in the
morning. In four subjects, confinement to bed did not substantially alter
this pattern. Heart rate variability was much reduced in four of the
subjects, but relatively normal in two in whom blood pressure variation was
also less abnormal. There was a correlation of the nadir of the blood
pressure measurements with the reported time of peak incidence of
orthostatic symptoms. These findings are of importance in both the
management and physiologic testing of patients with this condition.
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Circadian variation of blood pressure in autonomic failure
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