Morning hours are the period of the day characterized by the highest incidence of major cardiovascular events including myocardial infarction, sudden death or stroke. They are also characterized by important neurohormonal changes, in particular, the activation of sympathetic nervous system which usually leads to a rapid increase in blood pressure (BP), known as morning blood pressure surge (MBPS). It was hypothesized that excessive MBPS may be causally involved in the pathogenesis of cardiovascular events occurring in the morning by inducing hemodynamic stress. A number of studies support an independent relationship of MBPS with organ damage, cerebrovascular complications and mortality, although some heterogeneity exists in the available evidence. This may be due to ethnic differences, methodological issues and the confounding relationship of MBPS with other features of 24-hour BP profile, such as nocturnal dipping or BP variability. Several studies are also available dealing with treatment effects on MBPS and indicating the importance of long-acting antihypertensive drugs in this regard. This paper provides an overview of pathophysiologic, methodological, prognostic and therapeutic aspects related to MBPS.

Bilo, G., Grillo, A., Guida, V., Parati, G. (2018). Morning blood pressure surge: pathophysiology, clinical relevance and therapeutic aspects. INTEGRATED BLOOD PRESSURE CONTROL, 11, 47-56 [10.2147/IBPC.S130277].

Morning blood pressure surge: pathophysiology, clinical relevance and therapeutic aspects

Bilo, Grzegorz;GRILLO, ANDREA;Guida, Valentina;Parati, Gianfranco
2018

Abstract

Morning hours are the period of the day characterized by the highest incidence of major cardiovascular events including myocardial infarction, sudden death or stroke. They are also characterized by important neurohormonal changes, in particular, the activation of sympathetic nervous system which usually leads to a rapid increase in blood pressure (BP), known as morning blood pressure surge (MBPS). It was hypothesized that excessive MBPS may be causally involved in the pathogenesis of cardiovascular events occurring in the morning by inducing hemodynamic stress. A number of studies support an independent relationship of MBPS with organ damage, cerebrovascular complications and mortality, although some heterogeneity exists in the available evidence. This may be due to ethnic differences, methodological issues and the confounding relationship of MBPS with other features of 24-hour BP profile, such as nocturnal dipping or BP variability. Several studies are also available dealing with treatment effects on MBPS and indicating the importance of long-acting antihypertensive drugs in this regard. This paper provides an overview of pathophysiologic, methodological, prognostic and therapeutic aspects related to MBPS.
Articolo in rivista - Review Essay
ambulatory blood pressure monitoring; blood pressure variability; cardiovascular risk; morning blood pressure surge
English
2018
11
47
56
open
Bilo, G., Grillo, A., Guida, V., Parati, G. (2018). Morning blood pressure surge: pathophysiology, clinical relevance and therapeutic aspects. INTEGRATED BLOOD PRESSURE CONTROL, 11, 47-56 [10.2147/IBPC.S130277].
File in questo prodotto:
File Dimensione Formato  
10281-200456.pdf

accesso aperto

Tipologia di allegato: Publisher’s Version (Version of Record, VoR)
Dimensione 506.49 kB
Formato Adobe PDF
506.49 kB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/200456
Citazioni
  • Scopus 48
  • ???jsp.display-item.citation.isi??? 46
Social impact