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Blood pressure in the morning or at night are both significant cardiovascular risk predictors. Morning blood pressure either recorded with 24-h ambulatory blood pressure monitoring (ABPM) or self-measured at home predicted stroke and cardiovascular mortality in Asian populations. In 757 Chinese hypertensive patients, only morning blood pressure was independently associated with asymptomatic intracranial arterial stenosis. While in the IDACO (International Database on Ambulatory blood pressure in relation to Cardiovascular Outcome) study, nocturnal blood pressure was superior to daytime blood pressure in predicting mortality risk, but as similarly predictive as daytime for combined fatal and nonfatal cardiovascular events. Morning hypertension as well as nocturnal hypertension were prevalent in Chinese. In the 3548 patients registered in the ongoing China Ambulatory and home Blood Pressure Registry (ABPR) cohort study, the prevalence of morning or nocturnal uncontrolled hypertension both amounted to around 50%. In Chinese, isolated nocturnal hypertension was also prevalent (about 10%), and it was proved to be associated with increased cardiovascular risk, and the interaction between impaired renal proximal tubular sodium reabsorption and excess sodium intake. Several clock genes were also observed explaining a small variability of nocturnal and morning blood pressure. Current Chinese expert consensus recommended the use of long-acting drugs for the treatment of morning hypertension and for the goal of 24-hour blood pressure control.

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