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The Morning Blood Pressure Surge and All-Cause Mortality in Patients Referred for Ambulatory Blood Pressure Monitoring.
MedLine Citation:
PMID:  21490694     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BackgroundMorning blood pressure surge (MS) is accepted to increase cardiovascular risk, but it is not clear how it should be defined. Because dipping on 24-h ambulatory blood pressure monitoring (ABPM) associates with improved outcome we hypothesized that MS will not predict mortality independent of dipping.MethodsWe investigated a cohort of 2,627 patients referred for ABPM with available values for at least 1-h after awakening, and related them to all-cause mortality.ResultsDuring 22,353 person-years of follow-up, 246 patients died. We used Cox proportional hazards models to explore mortality associated with different definitions of the MS. Only the "1-h" MS (difference between average blood pressure (BP) 1-h before and after awakening) was related to mortality: after multiple adjustments including 24-h systolic BP, those whose "1-h" MS was above median (>12 mm Hg) had mortality hazard ratio (HR) of 0.61, 95% CI: 0.47-0.79, P < 0.001. In predetermined subgroup analyses, nondippers (n = 1,039), had a highly significant MS-related decrease in mortality: HR 0.49, 95% CI: 0.34-0.73, P < 0.001, unlike dippers (n = 1,588), HR = 0.90, 95% CI: 0.60-1.34.ConclusionAmong nondipping subjects referred for ABPM, the MS is associated with decreased mortality.American Journal of Hypertension (2011). doi:10.1038/ajh.2011.58.
Authors:
Sarah Israel; Ariel Israel; Iddo Z Ben-Dov; Michael Bursztyn
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-14
Journal Detail:
Title:  American journal of hypertension     Volume:  -     ISSN:  1879-1905     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
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