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The HOPE Asia network 2022 up-date consensus statement on morning hypertension management
Kazuomi Kario1, Ji-Guang Wang2, Yook-Chin Chia3,4
1Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
Journal of Clinical Hypertension (Greenwich, Conn.)
|October 5, 2022
Summary
Morning hypertension, a key target for blood pressure control, includes "morning surge" and sustained types. Effective management, especially in Asia, can reduce cardiovascular events.
Area of Science:
- Cardiology
- Hypertension Research
- Preventive Medicine
Background:
- Morning hypertension is a critical clinical target for achieving optimal 24-hour blood pressure control.
- It is classified into two types: the "morning surge" type with an exaggerated morning blood pressure surge (MBPS) and the "sustained nocturnal and morning hypertension" type (non-dipper/riser).
Purpose of the Study:
- To highlight the clinical significance of morning hypertension.
- To discuss the detection, pathogenic mechanisms, and treatment targets for morning hypertension.
- To emphasize the importance of managing morning hypertension, particularly in Asian populations.
Main Methods:
- Detection of morning hypertension using home and ambulatory blood pressure measurements (HBPM and ABPM).
- Assessment of cardiovascular and renal disease risks associated with different types of morning hypertension.
- Review of treatment guidelines and targets for morning blood pressure.
Main Results:
- Both types of morning hypertension elevate cardiovascular and renal disease risks, potentially through distinct mechanisms.
- Recommended morning BP target is <135/85 mmHg, with a stricter target of <125/75 mmHg for high-risk patients.
- Morning hypertension is more prevalent in Asian populations compared to Westerners.
Conclusions:
- Optimal management of morning hypertension, including home BP-guided treatment and ABPM, is crucial for reducing cardiovascular events.
- Tailored treatment strategies targeting morning BP are especially important for the Asian population due to higher prevalence.
- Achieving target morning BP levels (<135/85 mmHg or <125/75 mmHg for high-risk individuals) is essential.
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