In an 89-year-old man (FH), who monitored his blood pressure (BP) and heart rate (HR) aroundthe- clock at half-hour intervals for decades (with interruptions) and continued to do so before, during and after cataract surgery, we seek any alterations in the time structure of BP and/or HR in relation to this intervention (even though FH recognized no anxiety himself). First, we look at BP and HR within the individualized range of the subject at the given time by a sequential test, and second by reference to broader standards derived from clinically healthy peers of the same gender and corresponding age. The sequential test applied to detect any abnormalities used an individualized reference standard and found changes hidden in the normal range of peers, while data remained within that range. In the week following successful mid-week surgery, the circadian amplitude of diastolic BP increased above peer limits, a reason for caution in the interpretation of the results during the week of intervention as possibly related to subconscious anxiety about the surgery. If they were so related at all, these abnormalities were exceeded by the pleasure (in retrospect “tension”) associated with preparations of materials for publication at a conference, including this report. Apart from testing for physical or emotional loads (stress), we advocate, for any and all estimations of health more generally, a chronobiologically interpreted ambulatory automatic 7-day/24-hour BP and HR monitoring (C-ABPM) as soon as an appointment for a preoperative or any other health check is made, including cataract surgery.

University of Minnesota Minneapolis Minnesota USA

Lit.: 48