Relationship Among Morning Blood Pressure Surge, 24-Hour Blood Pressure Variability, and Cardiovascular Outcomes in a White Population

Prognosis in Relation to Blood Pressure Variability

“…Cardiovascular mortality, irrespective of adjustment, was unrelated to the preawakening morning surge (P≥0.12). Along similar lines, in this italian population study, 23 there were no differences in the risks of total and cardiovascular mortality when the bottom and top tenths of the distributions of the sleep-through and preawakening morning surge were compared (P≥0.39). …”

“…Furthermore, the risk of death or a major cardiovascular event in the 50th percentile group of the sleep-through morning surge was over 35% lower (P<0.01) than the average risk in the whole study population. 21 in the pressioni Arteriose Monitorate e Loro Associazioni (pAMeLA) study, Bombelli et al 23 analyzed ambulatory blood pressure data of 2011 people. Cardiovascular mortality showed a positive relation with the sleep-through morning surge in unadjusted analyses (Hr, 1.3; Ci, 1.1-1.6), which disappeared after adjustment for covariables (Hr, 0.9; Ci, 0.7-1.1).…”

“…3,16,17 several publications proposing that the magnitude of the morning blood pressure surge predicted stroke, 18 in particular cerebral hemorrhage, 19 or cardiovascular endpoints 20 remained unconfirmed in recently published large-scale observational studies. [21][22][23] this review will address the current controversy on the morning blood pressure surge, highlight the methodological problems in capturing blood pressure variability, and illustrate how large international population studies and a clinical trial do not support blood pressure variability as target in the management of hypertension.…”

Ethnic Differences in the Degree of Morning Blood Pressure Surge and in Its Determinants Between Japanese and European Hypertensive Subjects

“…In Japanese elderly hypertensive patients, a significant association between stroke and the degree of MS was found, 10 whereas this was not the case when an international ABPM database or a European ABPM database was analyzed. 12,14,15 In the latter case, the inability to find a significant relationship between BP MS and cerebrovascular events was suggested to possibly depend on the occurrence of a different degree of sleep-trough MS among different ethnic groups contributing to this database, 3 but to date, no data are available on the occurrence of systematic differences in BP MS when comparing subjects of different ethnic origin.…”

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

“…8 Furthermore, morning SBP surge is directly related to 24-h SBP variability and future cardiovascular events. 9 Prior research found morning SBP surge to be associated with stroke events independently of nocturnal BP falls and 24-h SBP in hypertensive patients. 5 This finding could result from the link between greater arterial stiffness, as measured by carotid-femoral pulse wave velocity, and higher morning SBP.…”