Older age (OR 1.21), regular alcohol drinking (OR 1.51), and beta-blocker use (OR 1.50) were independent determinants of an exaggerated morning minus evening systolic BP difference (>15 mm Hg).
Observational (n=969)
What are the determinants of an exaggerated morning minus evening systolic blood pressure difference in medicated hypertensive patients?
Older age, regular alcohol consumption, and beta-blocker use are independent determinants of an exaggerated morning-evening blood pressure difference in treated hypertensive patients.
Effect estimate: OR 1.21 (95% CI 1.04-1.42)
p-value: p=0.01
BACKGROUND: Morning blood pressure (BP) surge in ambulatory BP monitoring was a risk factor for stroke in our previous study. We studied the determinants of the morning minus evening systolic BP difference (ME difference) in self-measured BP monitoring, as a possible risk factor for stroke in medicated hypertensive patients. METHODS: Nine hundred sixty-nine hypertensive outpatients receiving stable antihypertensive drug treatment were studied using self-measured BP monitoring in the morning and evening. RESULTS: The ME difference ranged from -37.3 to 53.3 mm Hg (mean 7.9 mm Hg). The highest quartile (Q4) of the ME difference group (>15.0 mm Hg) had older age (68.0+/-9.8 years v 66.2+/-10.3 years, P=.01) and higher prevalence of men (48.3% v 39.9%, P=.02), regular alcohol drinkers (34.7% v 26.0%, P=.01) and beta-blocker use (26.9% v 19.9%, P=.03) than the other quartile groups (Q1 to Q3), whereas there was no significant difference in the average of morning and evening (ME average) BP. In logistic regression analysis controlling for ME average and other confounding factors, independent risks for Q4 of ME difference were older age (10 years older: odds ratio OR 1.21, P=.01, 95% confidence interval (CI) 1.04-1.42), regular alcohol drinker (OR 1.51, P=.04, 95% CI 1.01-2.26), and beta-blocker use (OR 1.50, P=.02, 95% CI 1.06-2.12). CONCLUSIONS: Older age, beta-blocker use, and regular alcohol drinking were significant determinants of the exaggerated ME difference in medicated hypertensive patients.
Ishikawa et al. (Fri,) conducted a observational in Medicated hypertension (n=969). Determinants of morning minus evening systolic BP difference was evaluated on Highest quartile (Q4) of the morning minus evening systolic BP difference (>15.0 mm Hg) (OR 1.21, 95% CI 1.04-1.42, p=0.01). Older age (OR 1.21), regular alcohol drinking (OR 1.51), and beta-blocker use (OR 1.50) were independent determinants of an exaggerated morning minus evening systolic BP difference (>15 mm Hg).