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Nocturnal Strokes and Arterial Hypotension

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Bowman Gray School of Medicine
Winston-Salem, N. C.

Ann Intern Med. 1968;68(5):1132-1133. doi:10.7326/0003-4819-68-5-1132
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Zulch and Hossman (1) recently reported that arterial blood pressure fluctuates in a diurnal rhythm that has mid-morning and early evening peaks and a nocturnal trough with a nadir occurring sometime between midnight and 4 AM. Because the hypotensive phase in the biorhythm of blood pressure coincides with the time when cerebral infarctions most commonly occur, they have postulated that hypotension may be the mechanism underlying some of these episodes. Their suggestion, while intriguing and possibly correct, is founded on hypothesis, not evidence. While it is true that the onset of cerebral infarctions is usually during repose, there is no


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