Morning Blood Pressure Surge and Nighttime Blood Pressure in Relation to Nocturnal Sleep Pattern and Arterial Stiffness

Suh, Min Hee; Barksdale, Debra J.; Logan, Jeongok G.

doi:10.1097/jcn.0b013e318291ee43

Cited by 18 publications

(15 citation statements)

References 39 publications

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“…Suh et al . () studied 30 healthy Korean American women aged 25–60 years and concluded that there was a possible link between disturbed sleep and morning surge. Our study showed that behaviour and chronotherapy intervention could improve BP surge in the morning, which could decrease the cardiovascular events.…”

Section: Discussionmentioning

confidence: 99%

The effect of continuous nursing intervention guided by chronotherapeutics on ambulatory blood pressure of older hypertensive patients in the community

Cheng

Zhang

et al. 2014

Journal of Clinical Nursing

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Section: Discussionmentioning

confidence: 99%

The effect of continuous nursing intervention guided by chronotherapeutics on ambulatory blood pressure of older hypertensive patients in the community

Cheng

Zhang

et al. 2014

Journal of Clinical Nursing

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“…5 This finding could result from the link between greater arterial stiffness, as measured by carotid-femoral pulse wave velocity, and higher morning SBP. 10 Basal sympathetic tone and the risk of hypertension (HTN) and related cardiovascular disease both vary with ethnicity. 11 African Americans have a disproportionately high prevalence and severity of HTN compared with other racial groups in the USA.…”

mentioning

confidence: 99%

Differences in Dynamic Diurnal Blood Pressure Variability Between Japanese and American Treatment-Resistant Hypertensive Populations

Kario

Bhatt

Brar

et al. 2017

Circ J

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Background: Dynamic diurnal changes in 24-h ambulatory systolic blood pressure (SBP) are associated with increased cardiovascular risk. We compared ambulatory BP dynamics in Japanese and American black and white populations with treatment-resistant hypertension. Methods and Results:Both HTN-Japan (n=41) and SYMPLICITY HTN-3 (n=384 white and n=140 black patients) enrolled patients with office SBP ≥160 mmHg and 24-h ambulatory SBP ≥135 mmHg while on ≥3 antihypertensive medications. Indices of circadian variation in ambulatory BP, including morning and nighttime dynamic surges, were retrospectively compared. All 3 cohorts had similar baseline office SBP. The Japanese cohort had significantly lower body mass index, less obstructive sleep apnea, and less hypercholesterolemia than the black and white cohorts, but significantly greater morning SBP levels, including moving peak morning SBP (183 vs. 169 vs. 169 mmHg, P<0.001), morning dynamic surge (37.9 vs. 28.6 vs. 24.2 mmHg, P<0.001) and nighttime dynamic surge (24.9 vs. 8.3 vs. 7.7 mmHg, P<0.001). These racial differences in SBP surge parameters persisted despite adjustment for baseline demographic population differences through multivariate regression. Conclusions:Greater diurnal BP variability, including dynamic surges, in Japanese compared with black and white patients may indicate ethnic differences in the underlying BP regulatory mechanism of resistant hypertension. These differences may be important to take into consideration for more specific drug and device-based therapy strategies based on ethnicity.

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“…30 There is a paucity of studies investigating the relationship between arterial stiffness and MBPS. Suh et al 2 studied the association of MBPS with PWV in healthy Korean women. They showed that although arterial stiffness did not show significant association with MBPS, it was associated with higher morning BP.…”

Section: Discussionmentioning

confidence: 99%

“…28 Because pulse wave travels faster in arteries with decreased elasticity, arterial stiffness could be measured by PWV. 2 Augmentation index (AIx) is a composite index that integrates the amount of wave that is reflected back to aorta and the velocity of incident and reflected wave. 29 Aortic PWV and AIx are indices of arterial stiffness and are predictors for cardiovascular diseases.…”

Section: Discussionmentioning

confidence: 99%

“…The phenomenon that BP rises sharply in the morning is called 'Morning Blood Pressure Surge' (MBPS). MBPS has been reported to occur in response to sudden activation of the sympathetic nervous system and increased α-mediated sympathetic activity, 2 and can be measured reliably using ambulatory BP monitoring. MBPS is considered to be a cardiovascular risk factor.…”

Section: Introductionmentioning

confidence: 99%

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Morning blood pressure surge is associated with serum gamma-glutamyltransferase activity in essential hypertensive patients

Elsürer

Afsar

2014

J Hum Hypertens

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The phenomenon that blood pressure rises sharply in the morning is called 'Morning Blood Pressure Surge' (MBPS). Serum gamma-glutamyltransferase (GGT) is a proinflammatory marker involved in the pathogenesis of cardiovascular diseases. Although both are novel cardiovascular risk factors associated with inflammation and atherosclerosis, the specific relationship between MBPS and serum GGT is unknown. This study investigates the relationship between MBPS and serum GGT activity in essential hypertensive patients. Totally, 320 hypertensive patients were recruited. Mean MBPS was 17.0 ± 12.9 mm Hg. MBPS was positively correlated with age (r = +0.222, P < 0.0001), body mass index (r = +0.132, P = 0.018), GGT (r = +0.271, P < 0.0001), daytime augmentation index adjusted for heart rate (AIx@75) (r = +0.140, P=0.014), 24-h pulse wave velocity (PWV) (r = +0.143, P = 0.014) and daytime PWV (r = +0.158, P = 0.007). From the 25th to 75th quartile of serum GGT, MBPS increased significantly (Ptrend < 0.0001). In multivariate linear regression analysis, MBPS was independently associated with age (P = 0.002), dipping status (P < 0.0001) and logGGT (P < 0.0001). In conclusion, MBPS is independently associated serum GGT activity in essential hypertensive patients. This is the first study in the literature to demonstrate an independent and a dose-response relationship between the two novel cardiovascular risk factors, MBPS and serum GGT, in this patient population.

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Morning Blood Pressure Surge and Nighttime Blood Pressure in Relation to Nocturnal Sleep Pattern and Arterial Stiffness

Abstract: Our findings imply a possible link between disturbed sleep and MBPS. Clinicians should understand the importance of the modification of altered sleep pattern for reducing MBPS in nonhypertensive participants.

Cited by 18 publications

References 39 publications

The effect of continuous nursing intervention guided by chronotherapeutics on ambulatory blood pressure of older hypertensive patients in the community

The effect of continuous nursing intervention guided by chronotherapeutics on ambulatory blood pressure of older hypertensive patients in the community

Differences in Dynamic Diurnal Blood Pressure Variability Between Japanese and American Treatment-Resistant Hypertensive Populations

Morning blood pressure surge is associated with serum gamma-glutamyltransferase activity in essential hypertensive patients

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