Cardiovascular events have their greatest prevalence in the early morning period. Whether this is attributable to an arousal-dependent blood pressure (BP) increase is far from being clear. It is also not clear to what extent this phenomenon reflects overall 24-hour BP variability. In 2051 subjects (aged 25-74 years) representative of the population of Monza (Italy), we measured 24-hour ambulatory systolic BP (SBP) and calculated the difference between the 2-hour average values after morning arousal and the lowest 3 or average 2-hour values before arousal (morning BP surge 1 and 2, respectively). For either measure, we sought the relationship with a variety of indices of 24-hour SBP variability and collected information on (1) the occurrence of cardiovascular and all cause deaths during a follow-up of ≈16 years and (2) the appearance of echocardiographic left ventricular hypertrophy after 10 years from the baseline visit. Morning SBP surge 1 was directly related to indices of 24-hour SBP variability, including those made independent on the magnitude of the day-night SBP difference. There was a weak positive relationship between morning SBP surge 1 and the risk of cardiovascular and all-cause death, which disappeared after adjustment for confounders. This was the case also for development of left ventricular hypertrophy. Morning SBP surge 2 was smaller, inconsistently related to 24-hour SBP variability and not at all related to fatal events or new-onset left ventricular hypertrophy. In a white population, morning BP surge was not found to be an independent predictor of cardiovascular death, all-cause death, or development of high cardiovascular risk (as documented by new-onset cardiac damage) even when appropriately assessed by measures that reflect its association with 24-hour BP variability.
Bombelli, M., Fodri, D., Toso, E., Macchiarulo, M., Cairo, M., Facchetti, R., et al. (2014). Relationship among morning blood pressure surge, 24-hour blood pressure variability, and cardiovascular outcomes in a white population. HYPERTENSION, 64(5), 943-950 [10.1161/HYPERTENSIONAHA.114.03675].
|Citazione:||Bombelli, M., Fodri, D., Toso, E., Macchiarulo, M., Cairo, M., Facchetti, R., et al. (2014). Relationship among morning blood pressure surge, 24-hour blood pressure variability, and cardiovascular outcomes in a white population. HYPERTENSION, 64(5), 943-950 [10.1161/HYPERTENSIONAHA.114.03675].|
|Tipo:||Articolo in rivista - Articolo scientifico|
|Carattere della pubblicazione:||Scientifica|
|Presenza di un coautore afferente ad Istituzioni straniere:||No|
|Titolo:||Relationship among morning blood pressure surge, 24-hour blood pressure variability, and cardiovascular outcomes in a white population|
|Autori:||Bombelli, M; Fodri, D; Toso, E; Macchiarulo, M; Cairo, M; Facchetti, R; Dell'Oro, R; Grassi, G; Mancia, G|
BOMBELLI, MICHELE (Primo)
FODRI, DANILO (Secondo)
GRASSI, GUIDO (Penultimo)
MANCIA, GIUSEPPE (Ultimo)
|Data di pubblicazione:||2014|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1161/HYPERTENSIONAHA.114.03675|
|Appare nelle tipologie:||01 - Articolo su rivista|