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The impact of the day of the week on home blood pressure

the Finn-Home study

Juhanoja, Eeva P.; Puukka, Pauli J.; Johansson, Jouni K.; Niiranen, Teemu J.; Jula, Antti M.

doi: 10.1097/MBP.0000000000000156
Clinical Methods and Pathophysiology
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Objective The impact of the day of the week on home blood pressure (BP) level and day-to-day BP profile is unknown. Our objectives were to examine (i) how the initial measurement day of the week affects 3-day and 7-day mean home BP and (ii) the BP variation between different days of the week.

Participants and methods The study included a population sample of 1852 participants aged 44−74 years. Home BP was measured twice in the morning and evening on 7 consecutive days. The days of the week on which home BP was measured were recorded. BP means were compared with analysis of variance and the t-test.

Results There were no overall differences in mean systolic/diastolic BPs initiated on various days of the week (3-day means: P=0.15/0.66; 7-day means: P=0.11/0.55). Within-subject systolic/diastolic BP variation between different days of the week was small but significant (128.7±19.2–130.4±19.8/79.5±9.8–80.6±9.9 mmHg; P<0.001/<0.001). Systolic/diastolic BP was lowest during the weekend (Saturday–Sunday: 129.0±18.9/79.6±9.6 mmHg) and highest on Monday (130.4±19.8/80.6±9.9 mmHg), irrespective of the initial measurement day of the week (P for systolic/diastolic difference <0.001/<0.001). In subgroup analyses, the systolic/diastolic BP increase was greater from Saturday–Sunday to Monday among the employed than among the unemployed (1.8/1.3 vs. 0.8/0.7 mmHg; P=0.02/0.01).

Conclusion Seven-day home BP measurement can be initiated on any given day of the week. However, if a 3-day measurement is taken, it is recommended to keep in mind that BP is usually the lowest during the weekend, and highest at the beginning of the week, especially among the employed.

aChronic Disease Prevention Unit, National Institute for Health and Welfare

bDepartment of Medicine

cTyks and Turku Region Joint Emergency Services, Turku University Hospital, Turku, Finland

Correspondence to Eeva P. Juhanoja, MD, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Kiinamyllynkatu 13, 20520 Turku, Finland Tel: +358 50 464 1350; fax: +358 02 266 1689; e-mail: eeva.juhanoja@utu.fi

Received July 7, 2015

Received in revised form August 26, 2015

Accepted September 1, 2015

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