A2185 Prevalence and characteristics of exaggerated morning surge and morning hypertension in Chinese patients

Abstract

Objectives: Exaggerated morning blood pressure surge (MBPS) and morning hypertension (MHT) was associated with worse prognosis. Little is known about the size of MBPS and the prevalence and determinants of MBPS and MHT in Chinese. Methods: In the China Ambulatory and Home BP Registry (ABPR), we performed 24-h ambulatory BP monitoring. Exaggerated MBPS was a sleep-trough MBPS ≥35 mmHg. MHT was a mean ambulatory BP ≥135/85 mmHg in the first 2 hours after awakening. Results: In the 3575 registered patients (mean age, 56.7 years; women, 49.1%; hypertension, 86.8%), sleep-trough systolic MBPS averaged (SD) 20.5 (13.5) mmHg, and 13.5% had an exaggerated MBPS. MBPS was significantly associated with female sex, 24-h systolic BP, season and region distribution (P ≤ 0.03). MBPS was higher in spring (effect size β ± SE, 1.17 ± 0.40 mmHg, P = 0.004) and winter (1.75 ± 0.38 mmHg, P < 0.001), and lower in summer (−2.48 ± 0.44 mmHg, P < 0.001) as compared to the average level of MBPS of whole population. MBPS also varied according to the regions of China, being higher in the Southeast (1.63 ± 0.49 mmHg, P < 0.001), and lower in the Northwest (−2.64 ± 0.70 mmHg, P < 0.001) as compared to the average level of the whole population. MHT was observed in 54.4% of all patients and 42.4% of treated hypertensive patients with office BP < 140/90 mmHg (n = 1225). MHT was significantly (P ≤ 0.01) associated with male sex, age, body mass index, anti-hypertensive therapy, and region distribution. (P < 0.04). In contrast to the trend for MBPS, the prevalence of MHT was higher in the Northeast and lower in the Southeast, and the difference between the South and the North was significant (P ≤ 0.03) in all seasons except autumn. Conclusion: The size of MBPS in Chinese is modest, however, MHT is prevalent. MBPS and MHT had different determinants and differed across regions of Chin