Abstract

Some days it just doesn’t pay to get out of bed. As long recognized, there is an increased risk for heart attack, stroke, and sudden death in the first few hours of the morning.1,2 In this issue of Circulation , Kario and colleagues have shown that, as for strokes, this risk is associated with a morning surge in blood pressure.3 Among the 519 elderly hypertensives in this study, the risk of stroke identified by brain MRI was 2.7-fold greater among the 55 who were in the top decile of the degree of morning surge of systolic blood pressure compared with the remaining subjects. See p 1401 For their prospective study, blood pressures were measured by 24-hour ambulatory monitoring and the morning surge was defined as the difference between …

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