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November 4, 2014Journal of Clinical HypertensionOpen Access

Is it Morning Blood Pressure Surge or Extreme Nocturnal Dipping That Accounts for the Increased Stroke Risk in the Morning Waking Hours?

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Key result

Evidence remains conflicting on whether morning blood pressure surge or extreme nocturnal dipping independently accounts for the increased stroke risk observed in the early morning hours.

Why the study?

Does morning blood pressure surge or extreme nocturnal dipping increase the risk of stroke and cardiovascular events in hypertensive patients?

Population

Hypertensive patients discussed across multiple studies.

Comparison

Morning blood pressure surge and extreme… vs Lower morning blood pressure surge or…

Design

Editorial

Authors

DCDebbie L. CohenRTRaymond R. Townsend

Discussion

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Member takes

Overview

Should not yet guide antihypertensive timing in hypertension; leaves open whether morning surge or nocturnal dipping drives early stroke risk.

Structured PICO

Does morning blood pressure surge or extreme nocturnal dipping increase the risk of stroke and cardiovascular events in hypertensive patients?

P
Population
An editorial reviewing multiple observational studies on the association between morning blood pressure surge, extreme nocturnal dipping, and the risk of stroke and cardiovascular events in hypertensive patients.
E
Exposure
Morning blood pressure surge (evaluated at various thresholds such as >55 mm Hg, >41 mm Hg, or >23 mm Hg) and extreme nocturnal dipping.
C
Comparator
Lower morning blood pressure surge or non-dipping status.
O
Outcome
Stroke, cardiovascular events, and all-cause death.hard clinical

The clinical significance of morning blood pressure surge remains debated, with conflicting evidence on whether it independently predicts stroke or if extreme nocturnal dipping is the primary driver.

Limitations

  • The Kario study was performed in an older Japanese population known to have a higher risk of stroke and may not be readily applicable to populations in the United States or Europe.

Cite This Study

Cohen et al. (2014) conducted an editorial in Hypertension and stroke risk. Morning blood pressure surge and extreme nocturnal dipping was evaluated. Evidence remains conflicting on whether morning blood pressure surge or extreme nocturnal dipping independently accounts for the increased stroke risk observed in the early morning hours.

synapsesocial.com/papers/6a980d85cfa25b768ec636d8https://doi.org/10.1111/jch.12438
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Morning Blood Pressure Surge: Ready for Daily Clinical Practice?2009 · 3 citations
  2. 2Morning Surges in Blood Pressure2006
  3. 3Time for focus on morning hypertension: Pitfall of current antihypertensive medication2005 · 107 citations
  4. 4Prognostic Significance for Stroke of a Morning Pressor Surge and a Nocturnal Blood Pressure Decline2005 · 408 citations
  5. 5GW24-e3921 Association between the rate of the morning surge in blood pressure and cardiovascular events and stroke2013