Association of Morning Hypertension Subtype With Vascular Target Organ Damage and Central Hemodynamics

Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

Sang‐Hak Lee¹  Donghoon Choi¹  Seok‐Min Kang¹  Sungha Park¹  Chan Joo Lee¹  In‐Cheol Kim¹  Jaewon Oh¹  Kazuomi Kario² 

[1] Cardiology Division, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea;Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan;

关键词: ambulatory blood pressure monitoring;    arterial stiffness;    hypertension;    morning hypertension;    nocturnal hypertension;   

DOI  :  10.1161/JAHA.116.005424

来源: DOAJ

【 摘 要 】

BackgroundA recent study reported that morning hypertension is associated with poor cardiovascular outcomes in hypertensive patients. However, it is unclear whether morning hypertension associated with sustained nocturnal hypertension and that associated with morning blood pressure (BP) surge differ in terms of their effects on cardiovascular target organ damage and clinical outcomes. The present study aimed to determine the association of morning hypertension with/without nocturnal hypertension with vascular target organ damage and central hemodynamics in patients at high risk for cardiovascular disease. Methods and ResultsAmbulatory BP monitoring was performed and central BP was measured in 1070 consecutive patients with high cardiovascular risk. We grouped morning hypertension into the following 3 subtypes: (I) morning normotension; (II) morning hypertension without nocturnal hypertension; and (III) morning hypertension with nocturnal hypertension. Morning hypertension was noted in 469 (43.8%) patients and morning hypertension with nocturnal hypertension was noted in 374 (34.9%) patients. The central systolic/diastolic BP and carotid to femoral pulse wave velocity were significantly higher in the subtype III group than in the subtype I and II groups (all P<0.001). Subtype III (versus subtype I) was an independent predictor of central hypertension and high‐risk arterial stiffness (P<0.001 and P=0.018, respectively) but not vascular damage in a fully adjusted model (model Y). ConclusionsMorning hypertension, especially that associated with nocturnal hypertension, is related to high central BP and increased arterial stiffness. Further studies on whether morning hypertension with or without nocturnal hypertension is related to clinical outcomes should be performed. Clinical Trial RegistrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT02003781.

【 授权许可】

Unknown