Related Experiment Videos

Clinical implication of morning blood pressure surge in hypertension

Kazuomi Kario1, Kazuyuki Shimada, Thomas G Pickering

  • 1Department of Cardiology, Jichi Medical School, Kawachi, Tochigi, Japan. kkario@jichi.ac.jp

Journal of Cardiovascular Pharmacology
|February 12, 2004
PubMed

Insights

The morning blood pressure surge in elderly hypertensive patients is linked to silent cerebrovascular disease and increased stroke risk. Targeting this surge may improve cardiovascular event prevention.

Area of Science:

  • Cardiology
  • Neurology
  • Hypertension Research

Background:

  • Cardiovascular events, such as stroke, frequently occur in the morning.
  • The morning surge in blood pressure (BP) is a potential risk factor for hypertensive target organ damage and subsequent cardiovascular events.
  • Understanding the morning BP surge's impact on stroke risk in elderly hypertensive patients is crucial for preventative strategies.

Purpose of the Study:

  • To investigate the association between the morning blood pressure surge and silent hypertensive cerebrovascular disease and stroke risk in elderly hypertensive patients.
  • To determine if this association is independent of age and 24-hour ambulatory blood pressure levels.

Main Methods:

  • Prospective study involving elderly hypertensive patients.
  • Definition of morning blood pressure surge: increase from lowest sleep BP to average of first 2 hours after waking.
  • Statistical analysis to assess association with cerebrovascular disease and stroke risk, controlling for confounding factors.

Main Results:

  • A significant association was found between the morning blood pressure surge and silent hypertensive cerebrovascular disease and stroke risk.
  • This association remained significant even after adjusting for age, 24-hour ambulatory BP levels, and existing silent cerebrovascular disease.
  • A 10 mmHg increase in systolic morning BP surge was associated with a 22% increase in stroke risk.
  • Orthostatic hypertension, linked to sympathetic activity, was associated with increased morning BP surge and BP variability.

Conclusions:

  • The morning blood pressure surge is an independent risk factor for stroke in elderly hypertensive patients.
  • Targeting the morning BP surge with specific antihypertensive medications, alongside strict BP control, may enhance cardiovascular event prevention.

Related Concept Videos

Chronopharmacokinetics: Circadian Rhythms and Influence on Drug Response01:15

Chronopharmacokinetics: Circadian Rhythms and Influence on Drug Response

Circadian rhythms are cyclic changes that are crucial in plasma drug concentrations. Various standard circadian parameters, including core body temperature, heart rate, and other cardiovascular factors, directly impact disease states and the therapeutic response to drug therapy.
The time of drug administration is an important factor to consider, as it can influence the toxic dose of a drug. For example, a study conducted by Prins et al. in 1997 examined the effects of the timing of...
Measurement of Blood Pressure01:17

Measurement of Blood Pressure

Assessing blood pressure is a standard procedure executed in virtually all medical environments. The method utilized today was established over a hundred years ago by an innovative Russian doctor, Dr. Nikolai Korotkoff. The soft ticking noise, known as Korotkoff sounds, heard while taking blood pressure readings results from turbulent blood flow within the vessels. The apparatus required for this procedure includes a sphygmomanometer, a blood pressure cuff attached to a gauge, and a stethoscope.
Special considerations while measuring blood pressure01:28

Special considerations while measuring blood pressure

When assessing blood pressure (BP), healthcare professionals must consider various factors and potential unexpected outcomes to ensure accurate readings and provide proper patient care. Adhering to these guidelines is essential to achieving the most reliable results.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

Hypertension III: Clinical Manifestations and Diagnostic Studies

Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
Hypertension I: Introduction01:28

Hypertension I: Introduction

Hypertension is a widespread, long-term medical condition where blood pressure in the arteries remains elevated. It is characterized by systolic blood pressure readings of 130 mm Hg or above or diastolic blood pressure (DBP) readings of 80 mm Hg or higher. Unmanaged hypertension poses significant health risks, making the distinction between primary (or essential) hypertension and secondary hypertension crucial, as their management and implications vary.Primary HypertensionPrimary hypertension,...
Errors occurring during blood pressure monitoring01:25

Errors occurring during blood pressure monitoring

Blood pressure monitoring is a crucial clinical procedure in diagnosing and managing various cardiovascular conditions. Despite its significance, the accuracy of blood pressure measurements can be compromised by multiple factors, potentially leading to either falsely high or low readings. These inaccuracies are critical as they can significantly impact patient care. So, it is vital to understand these challenges deeply and adopt strategic approaches to minimize errors.
Several factors...