Ambulatory blood pressure monitoring has been associated with clinical outcomes better than office blood pressure (BP) monitoring. Recent study reported that morning blood pressure surge (MBPS) was associated with worse cardiovascular outcomes in hypertensive patients. There are not enough studies about the relationship between MBPS and central hemodynamics according to nocturnal hypertension.Design and Method:
ABPM, central BP and pulse wave velocity (PWV) were measured in 1064 consecutive subjects enrolled in Cardiovascular and Metabolic Disease Etiology Research Center - HIgh Risk Cohort (CMERC-HI, NCT02003781). MBPS was defined as (mean SBP within 2 hours after awake – lowest night SBP) > 35 mmHg and nocturnal hypertension as mean night SBP > 120 mmHg or DBP > 70 mmHg.Results:
MBPS was found in 467 (43.9%) patients and MBPS with nocturnal hypertension was in 262 (24.6%) patients. There were no significant difference in age, gender, hypertension, diabetes and dyslipidemia prevalence between MBPS with and without nocturnal hypertension group. Central SBP/DBP were not significantly different between MBPS and non-MBPS group. However, heart to femoral PWV (hfPWV) were higher (1098 ± 308 vs. 1056 ± 331 cm/s, p = 0.036) in MBPS group. Central SBP (117 ± 16 vs. 112 ± 17 mmHg, p = 0.007), hf PWV (1061 ± 306 vs. 984 ± 240 cm/s, p = 0.011) in MBPS without nocturnal hypertension group were significantly higher than in non-MBPS group. The MBPS patients with nocturnal hypertension had higher central SBP/DBP (127/78 ± 18/11 vs. 117/78 ± 16/8 mmHg, both p < 0.001), hfPWV (948 ± 272 vs. 916 ± 284 cm/s, p = 0.022) compared to those without nocturnal hypertension.Conclusions:
We reported that MBPS, especially with nocturnal hypertension was related to higher central BP and increased arterial stiffness. Further studies for assessing whether these differences of MBPS subgroups according to nocturnal hypertension in central hemodynamics relate to clinical outcomes should be warranted.