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Isolated Morning Hypertension is a Predictor of Cardiovascular Events in Treated and Well Controlled Hypertensive

Romina Diaz1, Jessica Barochiner2,3, Lucas Aparicio2

  • 1Hypertension Section, Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. rominadiaz.dra@gmail.com.

High Blood Pressure & Cardiovascular Prevention : the Official Journal of the Italian Society of Hypertension
|October 13, 2025
PubMed

Insights

Isolated morning hypertension (IMH) in treated patients with controlled blood pressure still increases cardiovascular risk. Home blood pressure monitoring is key to identifying and managing this risk.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Preventive Medicine

Background:

  • The prognostic significance of isolated morning hypertension (IMH) in treated hypertensive patients is not well understood.
  • Despite adequate overall blood pressure (BP) control, morning BP surges may elevate cardiovascular risks.

Purpose of the Study:

  • To investigate the association between isolated morning hypertension (IMH) and cardiovascular events in treated hypertensive patients with globally controlled BP.

Main Methods:

  • A cohort study involving 925 hypertensive patients on stable treatment.
  • Home blood pressure monitoring (HBPM) over four days to define IMH (morning BP >135/85 mmHg despite overall BP <135/85 mmHg).
  • Follow-up until April 30, 2020, for cardiovascular and cerebrovascular events, analyzed using Cox proportional hazards models.

Main Results:

  • Prevalence of IMH was 17.4% among the study participants.
  • Patients with IMH showed a significantly higher risk of cardiovascular events (HR 1.6, 95% CI 1.1-2.2; p=0.02) compared to those without IMH.
  • This association remained significant after adjusting for multiple cardiovascular risk factors.

Conclusions:

  • Isolated morning hypertension (IMH), identified via HBPM, is linked to increased cardiovascular and cerebrovascular event risk in treated hypertensive patients.
  • Monitoring and managing IMH are crucial for optimizing cardiovascular risk reduction in hypertensive individuals.
Abstract

Keywords:
Cardiovascular riskHome blood pressure monitoringIsolated morning hypertensionTreated hypertension

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