Mean and range of the ambulatory pressure in normotensive subjects from a meta-analysis of 23 studies

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Abstract

To perform a meta-analysis of published reports in an attempt to determine the mean and range of normal ambulatory blood pressure (BP), 23 studies including a total of 3,476 normal subjects were reviewed. Most studies were compatible with a mean 24-hour BP in the range of 115 to 12070 to 75 mm Hg, a mean daytime BP of 120 to 12575 to 80 mm Hg, and a mean nighttime BP of 105 to 11060 to 65 mm Hg. With weighting for the number of subjects included in the individual studies, the 24-hour BP averaged 11872 mm Hg, the daytime BP 123/76 mm Hg, and the nighttime BP 106/64 mm Hg. The night/day pressure ratio averaged 0.87 for systolic and 0.83 for diastolic BP, with ranges across the individual studies from 0.79 to 0.92 and from 0.75 to 0.90, respectively. If the mean ±2 standard deviation interval in the various studies was considered normal, the range of normality was on average 97 to 139/57 to 87 mm Hg for the 24-hour BP, 101 to 146/61 to 91 mm Hg for the daytime BP, and 86 to 127/48 to 79 mm Hg for the nighttime BP. Until the results of prospective studies on the relation between the ambulatory BP and the incidence of cardiovascular morbidity and mortality become available, the afore-mentioned intervals, which summarize the experience of 23 investigators, could serve as a temporary reference for clinical practice.

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