Relationship among morning blood pressure surge, 24-hour blood pressure variability, and cardiovascular outcomes in a white population
| Autor: | E. Toso, Giuseppe Mancia, Guido Grassi, Michele Bombelli, Rita Facchetti, D. Fodri, Mario Macchiarulo, M. Cairo, Raffaella Dell'Oro |
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| Přispěvatelé: | Bombelli, M, Fodri, D, Toso, E, Macchiarulo, M, Cairo, M, Facchetti, R, Dell'Oro, R, Grassi, G, Mancia, G |
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty morbidity White People Predictive Value of Tests Risk Factors cardiovascular disease Internal Medicine Prevalence Medicine Humans Blood pressure monitoring Intensive care medicine Morning Aged Ultrasonography business.industry Incidence blood pressure Middle Aged mortality Circadian Rhythm blood pressure monitoring ambulatory Blood pressure Italy Cardiovascular Diseases White population Ambulatory Emergency medicine Hypertension Female Hypertrophy Left Ventricular business Cardiovascular outcomes Follow-Up Studies |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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