Key result
High morning surge of systolic (HR 1.81; 95% CI 1.10-2.96) and diastolic (HR 1.98; 95% CI 1.19-3.28) blood pressure was associated with increased cardiovascular risk in treated hypertensive patients.
Why the study?
The prognostic value of morning surge of blood pressure in middle-aged treated hypertensive patients needed investigation.
Does high morning surge of blood pressure increase the risk of cardiovascular events in middle-aged treated hypertensive patients?
Cohort (n=1,073)
Does high morning surge of blood pressure increase the risk of cardiovascular events in middle-aged treated hypertensive patients?
Hazard Ratio: 1.81 (95% CI 1.1–2.96)
High morning surge of systolic and diastolic blood pressure is an independent predictor of increased cardiovascular risk in middle-aged treated hypertensive patients.
Morning surge may refine risk stratification in treated middle-aged hypertensives; leaves open whether targeting it improves outcomes.
We investigated the prognostic value of morning surge (MS) of blood pressure (BP) in middle-aged treated hypertensive patients. The occurrence of a composite end point (coronary events, stroke, and heart failure requiring hospitalization) was evaluated in 1073 middle-aged treated hypertensive patients (mean age 49 years). Patients with preawakening MS of BP above the 90th percentile (27/20.5 mm Hg for systolic/diastolic BP) were defined as having high MS of BP. During the follow-up (mean 10.9 years), 131 cardiovascular events occurred. After adjustment for various covariates, including known risk markers and ambulatory BP parameters, patients with high MS of systolic BP (hazard ratio 1.81, 95% confidence interval 1.10-2.96) and those with high MS of diastolic BP (hazard ratio 1.98, 95% confidence interval 1.19-3.28) were at higher cardiovascular risk than those with normal MS. In middle-aged treated hypertensive patients, high MS of systolic and diastolic BP is independently associated with increased cardiovascular risk.
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Coccina et al. (2019) conducted a cohort in Hypertension (n=1,073). High morning surge of blood pressure vs. Normal morning surge of blood pressure was evaluated on Composite end point (coronary events, stroke, and heart failure requiring hospitalization) (HR 1.81, 95% CI 1.10-2.96). High morning surge of systolic (HR 1.81; 95% CI 1.10-2.96) and diastolic (HR 1.98; 95% CI 1.19-3.28) blood pressure was associated with increased cardiovascular risk in treated hypertensive patients.
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