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IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING, VOL. 36, NO. 1 1 , NOVEMBER 1989

24 h Sequential Spectral Analysis of Arterial Blood Pressure and Pulse Interval in Free-Moving Subjects
MARC0 DI RIENZO, MEMBER, IEEE, PAOLO CASTIGLIONI, GIUSEPPE MANCIA, GIANFRANCO PARATI, AND ANTONIO PEDOTTI

Abstract-A procedure for the 24 h tracking of the 0.25, 0.1, and 0.05 Hz oscillations in blood pressure (BP) and pulse interval (PI) in ambulant subjects has been developed. It includes: 1) sampling of a 24 h intra-arterial BP recording, extraction of the systolic (S) and diastolic (D) BP and PI from each heart beat followed by storage into separate series; 2) high-pass filtering and a splitting of each series into consecutive records of 256 values; 3) estimation of power spectral density (PSD) via FFT in each stationary record, and finally, computation of the power of each target oscillation. Using this procedure we analyzed data from ten hospitalized free-moving subjects in whom BP was recorded by the Oxford technique. The results revealed different patterns of the 0.25, 0.1, and 0.05 oscillations over the day-night cycle, showing a differentiated involvement during the 24 h of the mechanisms responsible for such rhythmic phenomena. Moreover, in order to reinforce the meaning of the obtained results and to exclude the possible negative effects due to the drawbacks typical of the FFT algorithm, we also performed a second spectral estimate based on the AR modeling. The obtained results validates the FFT approach.

mation exists as to the dynamic behavior of these oscillations , namely whether they are continuously present in daily life and how they are modified by the day and night cycle. In our paper, we have addressed this problem by analyzing the 0.05, 0.1, and 0.25 Hz oscillations in blood pressure and pulse interval (the reciprocal of the heart rate) during a 24 h period in subjects leading a relatively normal life.
11. THE RUNNING ANALYSIS

Given the great amount of data involved, the analysis of 24 h ABP tracings had to be largely automatic and based on fast algorithms that could reduce the amount of time required. Furthermore, the blood pressure signal had to be dynamically conditioned in order to detect and remove the segments of data containing nonstationarities. In this context the FFT algorithm was used for the spectral estiI. INTRODUCTION mates because of its low computational complexity. HowLOOD pressure and heart rate variabilities contain ever, to exclude that the drawbacks of FFT (effect of imsystematic oscillations at around 0.25, 0.1, and 0.05 plicit windowing of the data, high variance of the Hz. Although the mechanisms of production and the estimation error, modeling of the noise) might adversely physiological significance of these oscillations have not affect the reliability of the results obtained, a second inbeen completely clarified, the 0.25 Hz oscillations (also dependent spectral analysis was performed in one subject named Traube-Hering waves) have been related to the using the autoregressive (AR) approach. As will be shown respiratory activity [SI, [lo], while the 0.1 Hz oscillations later, the second approach of analysis validated the first, (the so-called Mayer waves) have been ascribed to the justifying adoption of the FFT procedure for the running vasomotor activity induced by the baroreflex loop [7], spectral analysis in all subjects. [26], [27]. Less agreement exists concerning the nature of the 0.05 Hz oscillation even if some authors have sug- A . Data Collection and Preprocessing gested a link with the thermoregulatory system [6], [ l l ] , Ten ambulant patients hospitalized for a condition of ~31. mild essential hypertension were considered for the study. All the observations on the above mentioned oscillaIn each subject a 24 h intra-arterial blood pressure recordtions made use of short-lasting fragments of the arterial ing was taken about a week after his admission to hospital blood pressure and/or ECG signal collected while the anwhen treatments had been stopped. The BP tracings were imals or human beings under scrutiny were kept at rest or obtained by the Oxford technique [4], [ 141. Briefly, a thin subjected to standard stimuli (exercise, tilting, adminiscatheter was inserted percutaneously into a radial artery tration of drugs, etc.). Consequently, little or no inforand connected to an external transducer placed at the heart level. The pressure signal was modulated and stored on a Manuscript received October 18, 1988; revised February 23, 1989. portable magnetic cassette recorder fastened to the subM. Di Rienzo, P. Castiglioni, and A. Pedotti are with the Centro di Bioingegnena, Politecnico di Milano e Fondazione Pro Juventute Don jects belt. The recording was demodulated by a playback Gnocchi, 20148 Milano, Italy. unit and the pressure signal was sent to a VAX 750 for G. Mancia and G. Parati are with the Centro di Fisiologica Clinica ed the analysis. The overall frequency response of the transIpertensione, Milano, Italy. ducer-recorder-decoder apparatus was 0-8 Hz ( - 3 dB IEEE Log Number 8930482.

0018-9294/89/1100-1066$01.OO 0 1989 IEEE

DI RIENZO et a l . : BLOOD PRESSURE AND PULSE INTERVAL IN FREE-MOVING SUBJECTS

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level ) . Detailed technical descriptions of the recording device have already been reported [SI, [20]. During the monitoring period the patients were asked to conform to the hospital schedule for meals and sleep time. The rest of the time they were free to move within the hospital area and to take part in the social activities permissable to patients not confined to bed (playing cards, watching TV, meeting relatives, walking on the hospital green, etc.). Each blood pressure tracing was sampled at 166 Hz and digitized on 12 bits. The digital signal was purified from artifacts by an interactive procedure and subdivided into separate pulse waves from which systolic (S) and diastolic (D) blood pressures (BP's) were computed. In order to restrict the analysis to the single BP signal, the pulse interval (PI) was derived from the pressure signal by measuring the time interval between consecutive systolic peaks (comparisons between the PI values derived in this way and the correspondent R-R intervals from ECG were performed on several blocks of data showing no significant difference). Each parameter was stored into a series and processed in the following way: 1) The very low frequency components were removed. 2) The series were segmented into contiguous records of 256 values. 3 ) The records containing nonstationarities were detected and excluded. 4) The power spectral density (PSD) of each stationary record was estimated. 5) The powers of the 0.25, 0.1, and 0.05 Hz oscillations were calculated in each record.

where

A1 = 2.9406495 A2 = -2.8835002 A3 = 0.9428123 BO = 0.0000048 B1 = 0.0000143 B 2 = 0.0000143 B 3 = 0.0000048

are the coefficients of the Chebyshev filter [22]. The final output { v ( n )} was derived from { y ( n ) } by the following noncausal filtering:

u(n) = Alu(n

+ 1 ) + A2v(n + 2) + A 3 v ( n + 3)
(2)

+ BoY(n) + B l Y ( n + 1 ) + B 2 y ( n + 2)
+ B3Yb + 3)
where the coefficients were the same used in (1). Since

and

are the transfer functions of (1) and (2), respectively, it can be noted that

H2k) = Hl(l/Z).

(5)

B. Filtering and Data Segmentation

As mentioned above the spectral analysis of the SBP, DBP, and PI series was performed by splitting each series into contiguous records of 256 blood pressure waves. However, each series contained long term fluctuations having periods almost equal to or greater than the record size. Before proceeding with the spectral analysis, these very low frequency oscillations had to be filtered out, otherwise such oscillations would appear as linear trends in the single set of data. These slow periodicities were extracted from the raw series by using a two-stage filtering procedure based on a double application of a third-order low-pass Chebyshev filter. The characteristics of this procedure are as follows. 1) A narrow transition band in the transfer function of the filter. 2) A zero-phase shift. 3 ) A low computational load. In the first stage of the procedure an intermediate series { y ( n ) } was derived from the original input series { x ( n )} according to the following relation:

The relation (5) implies that H l ( z ) and H 2 ( z ) have an opposite phase shift and equal module when z is evaluated on the unit circle. Therefore, the overall transfer function of the filter H ( z ) = H l ( z )Hl( l / z ) has a zero-phase shift and an amplitude equal to the square of the amplitude of the single Chebyshev filter. This procedure provides a sharp filtering using just a few samples (14 in our case) without introducing any shift in the phase. The cutoff frequency of the filter is placed at w, = 0.025 rad/s, the amplitude of ripples in passband was 1 percent of the maximum gain, the rejection frequency was placed at w, = 0.075 rad/s, the attenuation in the stopband was greater than 99 percent ( -40 dB). Fig. 1 displays the amplitude of the frequency response of the entire twostage filter. The output of the numerical filter was subtracted from the original series. The high-pass filtered series was then subdivided into contiguous records of 256 values. About 400 records were obtained from each series. This number slightly varied from subject to subject because of the different number of heartbeats occumng over the 24 h. All the analyses hereafter described were performed on the single record.

y(n) = Aly(n

1)

+ A,y(n

2)

+ A 3 y ( n - 3)
(1)

C. Detection and Removal of Transients

24 h blood pressure tracings in free-moving subjects include sudden modifications of PI and BP levels. Segments containing these rapid transients should be detected and excluded from the subsequent spectral analysis. How-

+ B o x ( n ) + B l x ( n - 1) + B 2 x ( n - 2) + B3x(n - 3 )

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IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING, VOL. 36, NO. 11, NOVEMBER 1989
501

SBP

SBP

I 0
O.E

E E

0.6

BEATS

256

BEATS

256

(a)

(b)

0.0 0.00

BEATS

256

BEATS

258

0.05

0s

8.10

0.15

FREQUENCY
Fig. 1. Frequency response of the two-stage filter.
I

(C)

(4

PI

25-1

SBP

ever, care should be taken in order to avoid erroneous classification of the systematic fast periodicities contained in the data set (our target fluctuations) as nonstationarities. We used a procedure based on the reverse arrangements test [3] in preference to the most common run test because of its smaller sensitivity to oscillating variations. Each record of the SBP, DBP, and PI series was thus analysed as follows. The record was subdivided into 12 samples each containing 21 values and for each sample k (with k = 1 * 12), the sample mean ( x k ) and variance ( ak)were computed. The sequences made up by the 12 means and the 12 variances were separately analyzed by the reverse arrangement test which was applied at 5 percent significance level. If the sample means or variances were not found to be trend-free by the test the record was discarded. Whenever the ith record of one series (SBP or DBP or PI) was discarded, the corresponding ith record of the other two series were also discarded. Fig. 2 shows four records identified by the test as containing non-stationarities [panels (a), (b), (c), (d)] and two records [panels (e), (f)] containing a systematic fluctuation which were, on the contrary, properly evaluated and accepted by the test. In all subjects about 30 percent of the total number of records were removed by the test. No significant differences between the hourly percentage of the discarded records were found during the day and night.

-81iJ,

BEATS

-25J, 256 1

BEATS

258

(e)

(f)

--

Fig. 2. Example of records of 256 consecutive BP and PI values. (a)-(d) Records discarded by the reversal arrangements test because they contain abrupt transients. (e), ( f ) Records passing the test despite systematic fluctuations,

( 1 / 2 ) ( 1 - cos 0

(7r

*n*

10/N))

N/10

W(n)=

N/10 < n < 9/10 9/10 * N

*N

( 1 / 2 ) ( 1 - cos (a * ( N - n ) * lO/N))

n 5 N.

D. The FFT Spectral Estimate

The stationary records of each series were analyzed via FFT in order to extract the power associated with the oscillations to be studied. The leakage in the spectra due to the implicit time windowing of the data set was reduced by tapering each record with a 10 percent cosine taper [2], [5]. Mathematically, the tapering procedure corresponds to a multiplication in the temporal domain of the data record R ( n ) by the windowing function W ( n ) specified by

DI RIENZO et al.: BLOOD PRESSURE AND PULSE INTERVAL IN FREE-MOVING SUBJECTS

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In
subject: 1BE

PI

SBP

DBP

Fig. 3 . Sequential PSDs of SBP, DBP, and PI throughout the 24 h period. Data from one subject. The dotted lines refer to epochs in which the PSD could not be estimated because of nonstationarities contained in the data.

The results of this sequential FFT estimate obtained in one representative subject (1BE) are illustrated in Fig. 3 in a synoptic form.

E. Power of Oscillations
On the scaled frequency axis of the PSD we defined three regions associated with the target oscillations: the high frequency (HF) region ranging from 0.35 to 0.14 Hz (corresponding to periods from 2.8 to 7 s ) , the midfrequency (MF) region from 0.14 to 0.07 Hz (7-14 s ) , and the low frequency (LF) region from 0.025 to 0.07 Hz ( 1440 s ) . The area of the power in each region was computed and assumed to be the power of the related oscillation. Fig. 4(a) shows the 24 h record-to-record trend of the LF, MF, and HF powers for SBP, DBP, and PI in subject 1BE. It can be seen that all powers were characterized by a high variability. Pulse interval displayed a marked increase in LF power during the night, while there was a more modest increase in LF power of SBP and DBP during the early hours of the morning. During the night the MF power showed a drastic reduction for SBP and DBP; this decrease began at the start of sleep and ended when the subject awoke. Finally, during the night the HF power of PI increased while the HF power of DBP was reduced.

Figs. 3 and 4(a) also show that HF oscillations were concentrated into sharp peaks during the night (PI and SBP), while they were much more distributed during the day (SBP and DBP). The possible biological meaning of these modifications will be discussed later. 111. AVERAGED RESULTS FROM
ALL

SUBJECTS

The LF, MF, and HF powers obtained in each subject for consecutive records of 256 beats were averaged for a time span of 30 min separately for SBP, DBP, and PI. Because preliminary screenings showed large individual differences mainly in the magnitude of the PI power, the results were normalized by dividing individual power values by the square of the corresponding 24 h average PI [ 11. SBP and DBP powers were similarly processed. The normalized spectral data obtained in single subjects were averaged for the group as a whole and the results of this analysis are shown in Fig. 5 . The powers are expressed as percentage of the square of the overall 24 h means. It can be noted that the standard errors (represented in figure by the vertical lines on the bins) were roughly proportional to the mean values, indicating that the individual powers were not normally distributed. The statistical evaluation of the differences among the powers

1070

IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING, VOL. 36, NO. 1 1 , NOVEMBER 1989

FFT
mmHg2 SBP mmHg* DBP P I

2oo

HF

1 1
Hours

'"1

i
Hours

30001

1
Hours

(a)

AR
mmHg2
200

SBP

mm Hg 2

DBP

msec2

PI

I'"
loo]

200

MF

loo]
2oo\ HF

30001

Hours

Fig. 4. Powers of LF, MF, and HF oscillations throughout the 24 h in the same patient in Fig. 3. Data are shown separately for SBP, DBP, and PI. (a) Estimates obtained via FFT. (b) Estimates obtained via AR modeling.

DI RIENZO et a l . : BLOOD PRESSURE AND PULSE INTERVAL I N FREE-MOVING SUBJECTS

NORYALIZED POWER OF 24 h BP AND P I OSCILLATIONS Yo8118 f SE n.10
8.P

1071

""1

0.P

PI

IC

OJ

.........................

1'

1'

OJ.

. . . ,

.TT

J.

, ,

..,.

, ,

, , ,

..

,., .,

J.

, , ,

, .

, , ,

, , ,

, , ,

"1 *
O J . . . . , . . . 0 12

lh
i

I'
2 ;

. . .i o

24

. . .i 8
1 .

io

io

2h

&

1 ,

12

24

Oh

Fig. 5 . Powers of LF, MF, and HF oscillations throughout the 24 h shown as average (+SE) for the ten subjects of the study. Data are shown separately for SBP, DBP, and PI.

occumng throughout the 24 h was thus performed after a icant fall during the night, a pattern that was common to logarithmic transformation of the data [24]. Following this all individual subjects. stabilizing procedure, the transformed powers exhibited a The nighttime reduction of MF was followed by a sudquasi-normal distribution and the variations could thus be den increase at 7 a.m., i.e., in correspondence to the assessed by the two-tailed t-test at a 0.02 percent signifi- awakening phase. The HF power did not show any apprecance level. ciable modification over the 24 h. For the LF, MF, and HF powers separately considered, the t-test was reiterately applied to evaluate the differ- B. Diastolic Blood Pressure Powers ences between all possible pairs of powers obtainable from The results for the LF and MF were similar to those the 48 estimates performed during the 24 h. The statistical described for the SBP. The HF power displayed a designificance of the differences is shown in Fig. 6: the abscissa indicates the time of occurrence of the power taken crease during the night (from the 9 p.m. up to 6:30 a.m.), as first element of the pair, the ordinate indicates the time which was statistically significant. of the second power of the pair, and the asterisk indicates a significant difference. The results are summarized be- C. Pulse Interval Powers low, separately for SBP, DBP, and PI. During the daytime the LF power showed a remarkable degree of stability. A progressive increase of LF power A . Systolic Blood Pressure Powers was visible during the night and the first hours of the LF power was not markedly different over the 24 h. An morning, with a starting time at 8 p.m. and a maximum increase in this power from 5 a.m. to 7 a.m. was sug- at 6:30 a.m. The MF power did not exhibit significant oscillations gested by visual inspection. However, the significance of this rise was not supported by statistical analysis (presum- throughout the 24 h period, while the HF power was staably because of the large intersubject variability of this ble from 12 a.m. to 8 p.m., and then progressively rose oscillation). The MF power showed a drastic and signif- with a peak at 8 a.m. Again, however, this trend did not

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IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING, VOL. 36, NO. 1 1 , NOVEMBER 1989

STATISTICAL SIGNIFICANCE OF HALF HOUR DIFFERENCES I N POWER OF BP AND P I OSCILLATIONS

SBP
DBP
PI

8
12 16 YF 20

24
4

Fig. 6 . Statistical significance of the differences between the powers obtained in the various 30 min time spans over the 24 h (see text). Each graph refers to the panel of Fig. 5 labeled with the same letter. The asterisk indicates that the pair of powers occumng at the time indicated by the corresponding abscissa and ordinate are significatively different.

reach the level of statistical significance, because of high intersubject variability.

IV. VALIDATION OF

A . Model ZdentGcation The output y ( n) of a generical AR process is given by the following relation:
D

THE

PROCEDURE

To assess the reliability of the FFT-based procedure for estimating spectral powers throughout the 24 h, the BP tracing of the subject 1BE was also analyzed by the autoregressive (AR) modeling of the data. The raw 24 h BP recording was preprocessed, filtered, and segmented in records of 256 beats as in the FFT analysis. Then the ARderived spectrum of each record was calculated by the following: 1) Identifing the autoregressive process best fitting the data contained in the record. 2) Computing the poles of the AR model, locating the correspondent spectral peaks, and selecting the peaks centered in the regions corresponding to LF, MF, and HF oscillations. 3) Estimating the power of the spectral peaks.

where p is the order of the model

ak are the AR coefficients.

e ( n ) is a white noise input WN (0, X2) having zero-mean and variance equal to X2. The transfer function of this system in the z-plane is

(7)

The AR coefficients of the model were estimated using

DI RIENZO

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a l . : BLOOD PRESSURE AND PULSE INTERVAL IN FREE-MOVING SUBJECTS

1073

the Yule-Walker equations by the recursive algorithm of Levinson-Durbin. The order of the model was set at 15. The FPE and AIC criteria were computed as well but they invariably indicated orders lower than 15.

B. Spectral Peak Location The poles of the AR model are the roots of A ( 1/ z ) = 0. By writing the ith pair of complex conjugates poles of the model in the form
exp ( -Pi j w i ) (8) it can be assumed that a peak in the spectrum having a central frequency placed at wi corresponds to this pair of poles [28]. On this basis, the poles of A ( 1 / z ) were computed in each record and the peaks having a central frequency falling into one of the three frequency regions defined in Section 11-E were considered for further elaborations.

dowing, high variance of the estimation error, modeling of the noise) does not actually influence the results to an appreciable degree. Moreover, from these results it can be also concluded that the crude computation of the area of power in each frequency region leads to estimates of LF, MF, and HF powers that are similar to those obtainable by the more sophisticated and complex algorithm based on the AR approach.
V . DISCUSSION The time-domain analysis of BP and PI variability throughout the 24 h period in ambulant subjects has been proved to be a powerful tool for 1) investigating the mechanisms responsible for the neural cardiovascular regulation 1161, 1211, 2) improving the diagnosis of hypertension 1151, 1251, [ 171, and 3) checking the effectiveness of treatments 1191. At present, little attention has been directed to the relevance and the dynamical modulation over the 24 h of rhythmic components of BP and PI variability even though it has been suggested that there is a relation between some of these components and neural factors controlling the cardiovascular system. The purpose of this paper was to present a procedure for the running evaluation of a subset of these rhythmic components and to provide a description of changes in these fluctuations in response to the various circumstances of the patients daily life. The first finding of the study was that a large part (about 70 percent) of the BP tracings collected over the 24 h can be analyzed by the spectral approach although the subjects were not confined to bed during the monitoring period. From each recording we obtained about 300 spectral estimates that allowed a strict tracking of the 0.25, 0.1, and 0.05 Hz oscillations in BP and PI during the normal life. Our data also indicate that fast oscillations in BP and PI do occur throughout the 24 h period and that these oscillations do not show any systematic difference during the waking hours, but, on the contrary, they undergo marked systematic changes in relation to the day-night cycle. These changes consisted of the fact that the relatively high value of MF power of BP observed during the day dramatically dropped at night, a similar (although statistically less sound) phenomenon characterizing the HF power of DBP. This could simply be part of the reduction in the overall BP variability which take place at night 1171. However, in contrast with the MF and HF, the LF power for BP did not decrease and even showed a tendency to increase during sleep. The reduction in BP variability characterizing the night time is therefore accompanied by a reduction in some but not all fast oscillatory components of this phenomenon. The dissociation between fast rhythmic oscillations and overall variability phenomena was even more evident for PI. It is well known that PI variability decreases during the night. Yet all fast oscillatory components of PI were not less during the night as compared to the daytime and

C . Estimates of the Power of Peaks Using the AR approach, the power associated with each peak cannot be estimated directly from the AR spectrum, but must be analytically derived. We used the procedure suggested by Johnsen and Andersen 1121 and reported by Kay and Marple in 1131. Briefly, being the z-transform of the PSD
P(z) =
where

x2
A ( z ) A*( l / z * )

(9)

X2 is the variance of the noise,

the power of the ith peak at wi is approximately

P ( i ) = 2x Real (Residue of P ( z ) / z at z i )
where ResidueP0
Z

(10)

(z

zi)-atzi. P(Z>
Z

(11)

The power associated to each spectral peak was computed from (10) and (1 1). Fig. 4(b) shows the 24 h LF, MF, and H F powers obtained via AR modeling. It can be seen that the results were similar to those obtained via FFT [Fig. 4(a)]. The similarity concerned the envelope of the graphs and the magnitude of the powers, exceptions being the LF data for SBP and DBP which, in the AR method, showed a somewhat greater record-to-record variability. In this instance, however, a smoothing of the LF powers obtained from the AR spectra by averaging over few (three or four) consecutive records leads to results fully comparable with those obtained via FFT. Thus, it can be concluded that when a sequential power spectra estimate of BP and PI over the 24 h is required, the FFT and AR methods are almost equivalent. Therefore, the limitation inherent in the FFT approach (win-

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IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING, VOL. 36, NO. I I , NOVEMBER 1989

in the former condition some of them showed a clear-cut and statistically significant increase (LF and HF). This implies that the relations between fast rhythmic oscillations and overall BP and PI variabilities are markedly different from day to night, suggesting that in these two instances the mechanisms responsible for these phenomena are largely different. Our paper cannot explain the factors involved in the genesis of the rhythmic fluctuations of BP and PI and their changes over the 24 h. Some reasonable hypotheses, however, can be discussed. Firstly, talung previous observations which suggest that MF spectra are somewhat related to sympathetic vascular tone into account, the fall in MF spectra of BP at night may be ascribed to the well-known nocturnal reduction in sympathetic activity. Secondly, during the night, the increase in HF spectra of PI and the lack of changes in MF spectra of the same quantity may reflect the increase in vagal activity on the heart occurring during sleep as a result of central influences [ 181, and of an increased sensitivity of baroreceptor heart rate reflex. It may also depend, at least for the HF components, on mechanical factors such as the deepening and slowing of ventilation, which on the other hand, may be also responsible for vagal influences on the heart. This hypothesis is supported by the fact that in all the subjects (see the example of Fig. 3) the PI oscillatory components falling within the HF region (i.e., the region regarded as related to the respiratory activity) changed from a spread out to a peaked pattern from day to night, possibly reflecting the variation from a variable to a regular (deep and slow) ventilation from the former to the latter condition. This regular, slow, deep ventilation may also have mechanically affected HF spectra of BP, preventing their reduction by the reduced sympathetic tone as for the MF spectra of BP. It is more difficult to speculate on the LF changes observed in this study, because the nature of the LF fluctuations, sometimes referred to as reflecting thermoregulatory adjustments, is virtually unknown. The relationship between the MF and HF oscillations of BP and PI and the sympathetic and parasympathetic modulation of the cardiovascular system is a very crucial topic that deserves further clarifications. In case of that a close link between oscillations and neural activity is confirmed, the sequential spectral analysis of 24 h ABP recordings could be used to dynamically monitor these neural factors under different physiological and pathophysiological conditions in daily life. The last point demonstrated by our results is a large diurnal intra-individual variability in record-to-record spectral data [also observed when the AR approach was used, cf. Fig. 4(a) and (b)]. This implies that the amplitude of fast rhythmic cardiovascular fluctuations undergoes a marked modification when a subject is awake. Thus caution should be exercised in estimating this highly dynamic phenomenon from the analysis of short-lasting segments of BP and/or PI.

REFERENCES
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Giuseppe Mancia was born in 1940. He received the Italian degree (laurea) in medicine from the University of Siena, Siena, Italy, in 1964 and the Ph.D. in physiology from the University of Milan, Milan, in 1969. He was a NIH Fellow and Research Associate of the Mayo Clinic Foundation and a Visiting Professor at the Virginia University and the University of Adelaide. He is currently Professor of Medicine and Director of the Cattedra of Semeiotica Medica at the University of Milan. His scientific interest include neural control of the cardiovascular system, blood pressure variability, pathophysiological and clinical aspects of arterial hypertension, and clinical pharmacology of cardiovascular drugs.

Marco Di Rienzo (M87) was born in Rome, Italy, on July 9 , 1954. He received the doctoral degree in electronic engineering from the Politecnico of Milan, Milan, Italy, in 1980. Since 1980 he has been a career researcher of Centro di Bioingegneria, Milan. He is also temporary professor at the Faculty of Medicine of the Universita Statale, Milan. His research activities mainly concern the study of the cardiovascular system. Dr. Di Rienzo is member of IFMBE and IEEE
Computer Society

Gianfranco Parati was born in 1951. He received the Italian degree (laurea) in medicine from the University of Milan, Milan, Italy, in 1977. Since then he has been working as a Research Fellow at the Centro di Fisiologia Clinica e Ipertensione, Ospedale Maggiore, Milano and at the Institute of Clinica Medica Generale e Terapia Medica, University of Milan. His research activity involves the study of neural control of the cardiovascular system, the analysis of blood pressure and heart rate signals obtained by ambulatory monitoring technique, and the pathophysiology of arterial hypertension.

Paolo Castiglioni was born in Varese, Italy, in 1961. He received the Italian degree (laurea) in electronic engineering in 1987 from Politecnico of Milan, Milan, Italy. He is currently involved in research projects of Centro di Bioingegneria, Milan, Italy. His scientific interests are in biomedical signal analysis and system modeling (mainly concerning the cardiovascular system).

Antonio Pedotti was born in Voghera, Italy, on March 21, 1944. He received the doctoral degree in electronic engineering from the Politecnico of Milan, Milan, Italy, in 1968. Since 1968 he has been a Researcher of the National Research Council. Presently he is Professor at the Engineering Faculty, Politecnico of Milan and Director of the Bioengineering Center of Milan. His current activities in research concern the analysis of biological systems, with special regard to DOStUK and locomotion medical informatits and technological developments.