Morning Blood Pressure Peak Research Articles

Effect of morning blood pressure peak on early progressive ischemic stroke: a prospective clinical study

ObjectiveTo prospectively evaluate the effect of morning blood pressure peak (MBPP) on early progressive ischemic stroke (EPIS). Patients and MethodsA total of 135 patients with acute ischemic stroke were enrolled and completed all assessments. The patients were divided into EPIS group and non-EPIS group, with 22 and 113 cases in each group, respectively, according to the assessment of Scandinavian stroke scale within three days after onset. All cases received conventional treatment for stroke and its risk factors. 24 -h dynamic blood pressure monitoring was performed within 24 h after admission. Based on the 24 -h mean blood pressure, MBPP, morning blood pressure, and other risk factors for EPIS, we conducted a logistic regression analysis to evaluate whether MBPP was an independent risk factor for EPIS. ResultsMean systolic blood pressure, systolic and diastolic MBPP, morning systolic and diastolic blood pressure were all significantly higher in EPIS group than in non-EPIS group (p = 0.037, p = 0.001, p = 0.035, p = 0.003, p = 0.042, respectively). Logistic regression analysis showed that MBPP was an independent risk factor for EPIS (OR = 1.057, 95% CI 1.014–1.102, p = 0.009). Further stratified analysis showed that incidences of EPIS in patients with elevated MBPP combined with large artery atherosclerosis or small artery occlusion were comparable (41.2% vs. 25.0%, p = 0.367), and the systolic MBPP was significantly higher in morning EPIS group than in non-morning EPIS group (p = 0.041). ConclusionElevated systolic MBPP might be an independent risk factor for EPIS, and play a more obvious effect on EPIS manifesting in the morning especially.

The correlation of morning blood pressure peak with cognitive function in elderly masked hypertension patients

Objective To study the current status of morning blood pressure peak in elderly masked hypertension patients and study the correlation between morning blood pressure peak and cognitive function.Methods A total of 72 elderly masked hypertension patients were selected in this study,.Morning blood pressure peak was measured by ABPM examination.The patients were divided into three groups according to the morning blood pressure peak.Morning blood pressure peak ≤ 30 mmHg were divided into non-Morning blood pressure surge group ( NMS group),morning blood pressure peak ＞30 mmHg were divided into Morning blood pressure surge group ( MS group).The cognitive function scale was determined (MMSE and MoCA).T-test and linear regression analysis were performed.Results MMSE score(27.69±2.04) and MoCA scores(24.85 ± 1.52) in MS group were lower than NMS group (28.87 ± 1.34,26.54± 1.53) ( P ＜0.01 ).MMSE and MoCA scores were negatively correlated with the morning blood pressure peak ( r =- 0.308,- 0.447,P ＜ 0.01 ).Conclusions Elderly masked hypertension patients remained the phenomenon of the morning blood pressure peak,the morning blood pressure peak could lead to cognitive impairment. Key words: Blood pressure ; Hypertension/PP/PX; Cognition

Administration time-dependent effects of aspirin on blood pressure variability and morning blood pressure peak of non-hypertension patients with coronary heart disease

Objective: This study investigated the effects of low-dose aspirin on blood pressure variability and morning blood pressure peak of non-hypertensive patients with coronary heart disease who received aspirin at different times of the day, and was designed to explore the best time of administration of aspirin. Methods: According to guidelines for the diagnosis of hypertension, a total of 8 male patients who were in hospital during November 2010 to March 2011, diagnosed with coronary heart disease and normotensive were selected.

The relationship between morning blood pressure surge with carotid artery intima-media thickness in elderly hypertensive patients

Objective To study the relationship between morning blood pressure surge with carotid artery intima-media thickness in good controlled elderly hypertensive patients.Methods A total of 151well controlled elderly hypertensive patients was selected in this study.Through the ABPM examination,the morning blood pressure peak was calculated,and then these patients were divided into two groups according to the morning blood pressure peak.The patients whose morning blood pressure peak ≤30 mmHg were divided into non-morning blood pressure surge group (NMS group),and the patients whose morning blood pressure peak ＞ 30 mmHg were divided into morning blood pressure surge group (MS group).The carotid IMT of these patients was measured with ultrasonic detection.The hypertension-related factors with blood pressure and morning peak phenomenon and the impact of IMT were analyzed,and the relationship between the morning blood pressure peak and IMT was analyzed with linear regression analysis.Results Two groups of 151 cases were well-controlled hypertension,76 patients with morning blood pressure showed peak phenomenon,accounting for 50.3％.Age,gender,body mass index,blood lipids,blood glucose,the maximum systolic blood pressure,average systolic blood pressure,minimum systolic blood pressure,maximum diastolic blood pressure,average diastolic blood pressure and minimum diastolic blood pressure had no difference between the two groups ( P ＞ 0.05 ).However,the morning blood pressure peak in patients with MS group [ (42.34 ± 7.10)mmHg] and IMT [ (0.89 ± 0.13 )mm] was higher than the NMS group [ (21.16 ±5.23) mmHg,(0.84 ±0.14) mm,P ＜0.01 orP ＜0.05],and carotid IMT and peak morning blood pressure was positively correlated ( r =0.56,P ＜0.01 ).Conclusions Good controlled elderly hypertensive patients remained the phenomenon of the morning blood pressure surge,the morning blood pressure peak might lead to carotid atherosclerosis. Key words: Hypertension/PA/PP; Blood pressure; Carotid arteries/PA

Regression of carotid atherosclerosis by control of morning blood pressure peak in newly diagnosed hypertensive patients

Morning blood pressure (BP) peak may be a risk factor for cardiovascular disease. Whether morning BP should be a target of hypertension treatment is not known. We investigated the relationship between morning BP variations, carotid internal-medial thickness (CIMT), circulating inflammatory markers, and sympathetic activity in hypertensive patients with different patterns of morning BP increase at baseline and after antihypertensive treatment. One hundred twenty-eight hypertensive patients with morning BP peak (MP+) were compared with 196 hypertensive patients without morning BP peak (MP-). All patients performed 24-h ambulatory BP monitoring, assessment of CIMT, circulating concentration of C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-18 (IL-18), and urinary catecholamines. Compared with MP- patients, MP+ patients had higher CIMT and urinary catecholamine output (P < .001), as well as CRP, IL-6, and IL-18 (P < .001). We randomly assigned 128 drug-naive MP+ patients to either metoprolol or carvedilol, two antihypertensive drugs with different effects on sympathetic activity. The primary outcome was change in CIMT and circulating inflammatory markers at 12 months. Morning BP decreased more among patients in the carvedilol group (P < .001), whereas clinic BP showed a similar decrease in both groups. The CIMT (P < .001), IL-6 (P < .001), IL-18 (P < .001), and CRP (P < .001) decreased more in the carvedilol group than in the metoprolol group. The CIMT regression was observed in 49% of patients in the carvedilol group and 18% of patients in the metoprolol group (P < .01). Reduction in CIMT was directly associated with changes in morning BP. Higher CIMT and circulating inflammatory markers coexist in hypertensive patients with morning BP peak, and might contribute to their increased cardiovascular risk. Carotid atherosclerosis can be prevented by control of morning BP.

Morning Blood Pressure Peak, QT Intervals, and Sympathetic Activity in Hypertensive Patients

We investigated the relation between morning blood pressure (BP) variations, sympathetic activity, and QT intervals in 156 never-treated subjects with essential hypertension and different patterns of morning BP increase. The morning BP peak (MP) was defined as a rise in systolic BP >or=50 mm Hg and/or diastolic BP >or=22 mm Hg during early morning (6:00 to 10:00 AM) compared with mean BP during the night. Clinical characteristics of patients with morning BP peak (MP+, n= 69, morning systolic BP=+54+/-4, diastolic BP=+32+/-5 mm Hg) did not differ from patients without BP peak (MP-, n= 87, morning systolic BP=+24+/-5, diastolic BP=+19+/-3 mm Hg). The daytime (10:00 AM to 10:00 PM) and the nighttime (10:00 PM to 6:00 AM) BP profile did not differ between the two groups. During daytime and nighttime ECG monitoring, the corrected QT (QTc) interval, and QTc dispersion did not differ significantly between the two groups, whereas during the morning period the QT values were significantly broader in the MP+ group compared with the MP- group (P<or=0.001). Morning LF/HF ratio was significantly higher in MP+ patients than in MP- patients (P<or=0.02). Both systolic and diastolic morning BP, in combination with ratio LF/HF power, were significant predictors of QTc dispersion (adjusted R(2)=0.59, P<or=0.01) and QTc interval (adjusted R(2)=0.41, P<or=0.01), whereas inclusion of physical activity and echocardiographic parameters did not add explanatory information. The prolongation of cardiac repolarization times and morning sympathetic overactivity coexist in hypertensive patients with morning BP peaks, and they might contribute to raised cardiovascular risk in these patients.