Oxidative Stress by Peripheral Blood Mononuclear Cells Is Increased in Hypertensives with an Extreme-Dipper Pattern and/or Morning Surge in Blood Pressure

Maeda, Kensaku; Yasunari, Kenichi; Watanabe, Takanori; Nakamura, Munehiro

doi:10.1291/hypres.28.755

Cited by 38 publications

(32 citation statements)

References 27 publications

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“…In the present study, a high morning SBP, but not morning DBP or other BP variables, was significantly associated with impaired Valsalva-BRS. That may be because morning SBP has been reported to carry the strongest cardiovascular risk among ambulatory BP parameters (35,36,39). On the other hand, the morning BP surge, consisting of both high morning BP and low nighttime BP, was not associated with BRS in our study.…”

Section: Morning Hypertensioncontrasting

confidence: 53%

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Factors Associated with Baroreflex Sensitivity: Association with Morning Blood Pressure

et al. 2007

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Baroreflex sensitivity (BRS) is a primary mechanism for acute and chronic control of blood pressure (BP).However, there are few data showing the relationship between BRS and ambulatory BP (ABP). We assessed the hypothesis that BRS specifically contributes to some specific parameters of ABP in never-treated hypertensive/normotensive subjects. We studied 128 subjects (mean age: 54.5 ± 13 years, 60% male) consisting of 92 untreated hypertensive and 36 normotensive subjects. Radial tonometric BP and simultaneous RR interval were recorded for 10 min, and the Valsalva maneuver was performed 3 times for each subject. BRS was calculated in two ways: the spontaneous-BRS by the spectral method, and the Valsalva-BRS by the slope method, using commercial software. ABP monitoring was performed on the same day as the BRS test.

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Section: Morning Hypertensioncontrasting

confidence: 53%

“…There is a growing amount of evidence that high BP in the morning is associated with cardiovascular risk markers (35,36). However, the mechanisms of the morning BP rise have not been sufficiently clarified.…”

Section: Morning Hypertensionmentioning

confidence: 99%

Factors Associated with Baroreflex Sensitivity: Association with Morning Blood Pressure

et al. 2007

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“…However, none of these parameters were significantly related to either the basal or the stimulated level of HO-1. Overproduction of reactive oxygen species (ROS) as a possible cause of atherosclerosis and the protection against such stress by HO-1 occur locally in the vasculature and are mainly intracellular events (49). Systemic measurements of the markers of inflammation (50) and oxidative stress were not sufficiently sensitive to determine the relationship with HO-1 expression.…”

Section: Discussionmentioning

confidence: 99%

Reduced Expression of Heme Oxygenase-1 in Patients with Coronary Atherosclerosis

et al. 2007

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“…In a previous report, reactive oxygen species formation was measured by gated flow cytometry, and hypertensive patients with exaggerated morning BP surge had higher reactive oxygen species formation by mononuclear cells. 11 Although the morning BP surge is a physiological phenomenon, in the hypertensive patients, the degree of morning BP surge is exaggerated and is an independent risk for advancing the atherosclerotic process and target organ damage and triggering cardiovascular events. Thus, in addition to strict BP control, antihypertensive therapy targeting the morning BP surge along with plaque-stabilizing strategies using statins, peroxisome proliferator-activated receptor-␥ agonists, and inhibitors of the renin-angiotensin system could achieve more beneficial effect for prevention of cardiovascular disease in high-risk hypertensive patients.…”

mentioning

confidence: 99%

Vascular Damage in Exaggerated Morning Surge in Blood Pressure

Kario

2007

Hypertension

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R ecent clinical studies demonstrated that an exaggerated morning blood pressure (BP) surge is a risk for cardiovascular events, such as ischemic and hemorrhagic stroke. [1][2][3] Simultaneously, neurohumoral factors and various cardiovascular risk factors are exaggerated in the morning. Although the precise molecular mechanisms remain unclear, exaggerated morning BP surge has been closely associated with other cardiovascular risk factors potentiated in the morning (Figure). The main mechanisms of morning BP surge and associated neurohumoral activation on cardiovascular disease consist of progression of cardiovascular remodeling and atherosclerosis, as well as direct effects of BP surges that may trigger cardiovascular events.An exaggerated morning BP surge may advance vascular remodeling from the larger arteries to the small resistance vessel through increased mechanical pressure and shear stress of an exaggerated fluctuation of blood flow on the vessel wall. In hypertensive patients, morning BP surge and time of morning BP variability in the morning were significantly correlated with increased carotid intima-media thickness, and these associations were independent of 24-hour BP levels. 4 On the other hands, increased stiffness of large arteries increases BP variability through impaired baroreceptor sensitivity. This increase in BP variability is pronounced particularly in the morning, when compared with the other periods, 5 leading to cardiac hypertrophy. 6 In addition, small artery disease may also be associated with exaggerated morning BP surge. In our previous study on elderly hypertensive patients, silent cerebral infarcts, assessed by brain MRI, were significantly associated with exaggerated morning BP surge. 7 This association was prominent between multiple cerebral infarcts and morning BP surge and appeared to depend on ␣-adrenergic sympathetic activity. The reactivity of morning BP surge depends on the ␣-adrenergic vasoconstrictor response of small resistance vessel, and it may be closely related to remodeling of the small vessel. Thus, morning BP surge and vascular remodeling of various arterial sizes could form a vicious cycle of cardiovascular risk.As shown in the Figure, the morning BP surge also seems to have some role in the initial stage and the progression of atherosclerosis. In the model of sinoaortic denervation rat, which exhibits the marked BP variation, the neointimal formation after vascular injury was significantly increased. 8 In healthy subjects without atherosclerotic disease, flow-mediated vasodilation, which reflects endothelial function, was reduced early in the morning. Reduced endothelial function could contribute to the high BP reactivity in the morning. 9 In addition, because activity of the sympathetic nervous system and renin-angiotensin-aldosterone system is the highest in the morning, the impact of exaggerated BP variability in the morning to lead to endothelial cell damage and subsequent atherosclerosis would be greater than in other periods of the day.In this issue, Marfe...

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Oxidative Stress by Peripheral Blood Mononuclear Cells Is Increased in Hypertensives with an Extreme-Dipper Pattern and/or Morning Surge in Blood Pressure

Cited by 38 publications

References 27 publications

Factors Associated with Baroreflex Sensitivity: Association with Morning Blood Pressure

Factors Associated with Baroreflex Sensitivity: Association with Morning Blood Pressure

Reduced Expression of Heme Oxygenase-1 in Patients with Coronary Atherosclerosis

Vascular Damage in Exaggerated Morning Surge in Blood Pressure

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