首页|期刊导航|中华医学杂志（英文版）|Association between the rate of the morning surge in blood pressure and cardiovascular events and stroke
中华医学杂志（英文版）2013，Vol.126Issue(3)：510-514,5.DOI:10.3760/cma.j.issn.0366-6999.20122110
Association between the rate of the morning surge in blood pressure and cardiovascular events and stroke
Association between the rate of the morning surge in blood pressure and cardiovascular events and stroke
摘要
Abstract
Background The exaggerated surge in morning blood pressure (BP) that many patients experience upon awakening may be closely related to target organ damage and may be a predictor of cardiovascular complications.However,no previous studies have evaluated the rate of this surge independently of the evening period.It remains unclear whether the rate of increase experienced during the surge is a significant or independent determinant of cardiovascular events.Methods We randomly selected 340 ambulatory BP monitoring (ABPM) patients.All subjects without type 2 diabetes mellitus were divided into two groups:hypertensive group (n=170) and normotensive group (n=170).We analyzed ambulatory blood pressure recordings using a double logistic curve-fitting procedure to determine whether the magnitude of the surge in BP and heart rate (HR) in the morning is related to the level of BP in hypertensive individuals.We evaluated the association between the rate of the morning surge in systolic BP (SBP) and the incidence of myocardial infarction and stroke in normotensive and hypertensive subjects.Results Comparisons between hypertensive and normotensive subjects showed that the rates of the morning surges in SBP,mean BP (MBP),and diastolic BP (DBP) were greater in the hypertensive group (P ＜0.05) than in the normotensive group.The rate of morning surge in BP was found to be correlated with the daytime SBP (r=0.236,P ＜0.01),the difference between the day and night plateau (r=0.249,P ＜0.01),and the night SBP (r=-0.160,P ＜0.05),respectively.After controlling for age,sex,and mean systolic pressure within 24 hours (24 h SBP),the rate of morning surge in SBP was closely correlated with daytime SBP (r=0.463,P ＜0.001),night SBP (r=-0.173,P ＜0.05),and the difference between the day and night plateau (r=0.267,P ＜0.001).Logistic regression analysis revealed that the rate of morning surge in SBP was an independent determinant of myocardial infarction (OR=1.266,95％ CI=1.153-1.389,P ＜0.001) and stroke (OR=1.367,95％ CI=1.174-1.591,P ＜0.001).Conclusions The rate of the morning surge in BP is greater in hypertensive subjects than in normotensive subjects.Daytime SBP may be the best predictor of the rate of morning surge in SBP.The rate of the morning surge in BP is associated with cardiovascular and stroke events.关键词
circadian rhythm/ambulatory blood pressure/Logistic equation/hypertension/target organ damageKey words
circadian rhythm/ambulatory blood pressure/Logistic equation/hypertension/target organ damage引用本文复制引用
LUO Yu,WANG Yan-li,WU Ying-biao,XU Yao,Geoffrey A.Head,Macgrathy Barry,LIANG Yu-lu..Association between the rate of the morning surge in blood pressure and cardiovascular events and stroke[J].中华医学杂志（英文版）,2013,126(3):510-514,5.基金项目
This project was funded by the International Cooperation Projects of Shanghai Science and Technology Commission,China (No.054107066). （No.054107066）
