PS 11-41 ASSOCIATION BETWEEN BODY MASS INDEX AND MORNING SURGE IN PATIENTS WITH ESSENTIAL HYPERTENSION

Abstract

Objective: Obesity is an important risk factor for cardiovascular events via impaired glucose and lipid metabolisms and hypertension. Exaggerated morning blood pressure (BP) surge is also a risk for cardiovascular events. Although it is anticipated that obesity is associated with increased morning BP surge, this issue has not been fully investigated. In the present study, therefore, association between body mass index (BMI) and morning surge were investigated in patients with essential hypertension. Design and Method: Ambulatory BP monitoring (ABPM) was performed with an automatic device, TM-2431 (A&D, Tokyo, Japan) in patients with essential hypertension, and the morning surge in systolic BP was calculated by subtracting the 2-h average systolic BP before waking from the 2-h average systolic BP after waking. In addition, association between BMI and morning surge were investigated. Results: A total of 300 patients (135 males) were enrolled. The mean value for age was 57 ± 14 y.o., BMI 24.9 ± 4.6 kg/m2, triglyceride 146 ± 108 mg/dl, morning surge 16 ± 21 mmHg, and estimated glomerular filtration rate (eGFR) 75.3 ± 20.3 ml/min/1.73 m2. Morning surge showed significantly positive relationships with BMI (r = 0.329, p = 0.001), triglyceride (r = 0.233, p = 0.016), and eGFR (r = 0.204, p = 0.016) and significantly negative relationship with age (r = −0.312, p = 0.001). Multiple regression analysis testing age, gender, BMI, triglyceride, and eGFR as independent variables revealed that only BMI was significantly positively associated with morning surge (ß = 0.217, p = 0.036). Conclusions: High BMI was shown to be independently associated with increased morning BP surge. These data may suggest that morning BP surge is contributing, at least in part, to the high risk of cardiovascular evens in patients with obesity and hypertension. It is advisable that morning surge should be evaluated in these patients.