Document Detail


Exaggerated morning blood pressure surge and cardiovascular events. A 5-year longitudinal study in normotensive and well-controlled hypertensive elderly.
MedLine Citation:
PMID:  19070375     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cardiovascular events (CE) occur most frequently in the morning hours in hypertensive subjects. We studied the association between the morning blood pressure (BP) surge and CE in prognosis of 10 normotensive and 32 well-controlled hypertensive elderly, in whom ambulatory BP monitoring was performed and who were followed prospectively for 5 years. The morning surge (MS) of BP was calculated as mean systolic BP during 2h after awakening--mean systolic BP during 1h that included the lowest sleep BP. During an average of 60 months, five CE occurred. When the patients were divided into two groups according to MS, those in the top terzile (MS group; MS> or =34 mmHg, n=14) had a higher prevalence of CE (5 versus 0, p=0.001) during the follow-up period, than the others (non-MS group; MS<34 mmHg, n=28). The logistic regression analysis showed the MS sleep-trough surge as predictive variable of CE (odds ratio, OR=0.794, p=0.022). In conclusion, in older normotensives and well-controlled hypertensives, a higher BP MS is associated with vascular risk independently of clinical and ambulatory BP. Reduction of the MS could thus be a therapeutic target for preventing vascular events also in non-hypertensive patients.
Authors:
A Amici; P Cicconetti; C Sagrafoli; A Baratta; P Passador; T Pecci; G Tassan; W Verrusio; V Marigliano; M Cacciafesta
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Publication Detail:
Type:  Journal Article     Date:  2008-12-12
Journal Detail:
Title:  Archives of gerontology and geriatrics     Volume:  49     ISSN:  1872-6976     ISO Abbreviation:  Arch Gerontol Geriatr     Publication Date:    2009 Sep-Oct
Date Detail:
Created Date:  2009-07-14     Completed Date:  2009-10-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8214379     Medline TA:  Arch Gerontol Geriatr     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  e105-9     Citation Subset:  IM    
Affiliation:
Department of Aging Science, University of Rome La Sapienza, Policlinico Umberto I, Viale Policlinico 155, I-00160 Rome, Italy. alessandro.amici@uniroma1.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Antihypertensive Agents / therapeutic use
Blood Pressure / physiology*
Blood Pressure Monitoring, Ambulatory
Circadian Rhythm / physiology*
Female
Heart Diseases / etiology*,  physiopathology
Humans
Hypertension / complications,  drug therapy,  physiopathology*
Longitudinal Studies
Male
Middle Aged
Chemical
Reg. No./Substance:
0/Antihypertensive Agents

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