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Association of Morning Hypertension Subtype With Vascular Target Organ Damage and Central Hemodynamics
BACKGROUND: A recent study reported that morning hypertension is associated with poor cardiovascular outcomes in hypertensive patients. However, it is unclear whether morning hypertension associated with sustained nocturnal hypertension and that associated with morning blood pressure (BP) surge diff...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5523792/ https://www.ncbi.nlm.nih.gov/pubmed/28196818 http://dx.doi.org/10.1161/JAHA.116.005424 |
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author | Oh, Jaewon Lee, Chan Joo Kim, In‐Cheol Lee, Sang‐Hak Kang, Seok‐Min Choi, Donghoon Park, Sungha Kario, Kazuomi |
author_facet | Oh, Jaewon Lee, Chan Joo Kim, In‐Cheol Lee, Sang‐Hak Kang, Seok‐Min Choi, Donghoon Park, Sungha Kario, Kazuomi |
author_sort | Oh, Jaewon |
collection | PubMed |
description | BACKGROUND: A recent study reported that morning hypertension is associated with poor cardiovascular outcomes in hypertensive patients. However, it is unclear whether morning hypertension associated with sustained nocturnal hypertension and that associated with morning blood pressure (BP) surge differ in terms of their effects on cardiovascular target organ damage and clinical outcomes. The present study aimed to determine the association of morning hypertension with/without nocturnal hypertension with vascular target organ damage and central hemodynamics in patients at high risk for cardiovascular disease. METHODS AND RESULTS: Ambulatory BP monitoring was performed and central BP was measured in 1070 consecutive patients with high cardiovascular risk. We grouped morning hypertension into the following 3 subtypes: (I) morning normotension; (II) morning hypertension without nocturnal hypertension; and (III) morning hypertension with nocturnal hypertension. Morning hypertension was noted in 469 (43.8%) patients and morning hypertension with nocturnal hypertension was noted in 374 (34.9%) patients. The central systolic/diastolic BP and carotid to femoral pulse wave velocity were significantly higher in the subtype III group than in the subtype I and II groups (all P<0.001). Subtype III (versus subtype I) was an independent predictor of central hypertension and high‐risk arterial stiffness (P<0.001 and P=0.018, respectively) but not vascular damage in a fully adjusted model (model Y). CONCLUSIONS: Morning hypertension, especially that associated with nocturnal hypertension, is related to high central BP and increased arterial stiffness. Further studies on whether morning hypertension with or without nocturnal hypertension is related to clinical outcomes should be performed. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02003781. |
format | Online Article Text |
id | pubmed-5523792 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-55237922017-08-14 Association of Morning Hypertension Subtype With Vascular Target Organ Damage and Central Hemodynamics Oh, Jaewon Lee, Chan Joo Kim, In‐Cheol Lee, Sang‐Hak Kang, Seok‐Min Choi, Donghoon Park, Sungha Kario, Kazuomi J Am Heart Assoc Original Research BACKGROUND: A recent study reported that morning hypertension is associated with poor cardiovascular outcomes in hypertensive patients. However, it is unclear whether morning hypertension associated with sustained nocturnal hypertension and that associated with morning blood pressure (BP) surge differ in terms of their effects on cardiovascular target organ damage and clinical outcomes. The present study aimed to determine the association of morning hypertension with/without nocturnal hypertension with vascular target organ damage and central hemodynamics in patients at high risk for cardiovascular disease. METHODS AND RESULTS: Ambulatory BP monitoring was performed and central BP was measured in 1070 consecutive patients with high cardiovascular risk. We grouped morning hypertension into the following 3 subtypes: (I) morning normotension; (II) morning hypertension without nocturnal hypertension; and (III) morning hypertension with nocturnal hypertension. Morning hypertension was noted in 469 (43.8%) patients and morning hypertension with nocturnal hypertension was noted in 374 (34.9%) patients. The central systolic/diastolic BP and carotid to femoral pulse wave velocity were significantly higher in the subtype III group than in the subtype I and II groups (all P<0.001). Subtype III (versus subtype I) was an independent predictor of central hypertension and high‐risk arterial stiffness (P<0.001 and P=0.018, respectively) but not vascular damage in a fully adjusted model (model Y). CONCLUSIONS: Morning hypertension, especially that associated with nocturnal hypertension, is related to high central BP and increased arterial stiffness. Further studies on whether morning hypertension with or without nocturnal hypertension is related to clinical outcomes should be performed. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02003781. John Wiley and Sons Inc. 2017-02-14 /pmc/articles/PMC5523792/ /pubmed/28196818 http://dx.doi.org/10.1161/JAHA.116.005424 Text en © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Research Oh, Jaewon Lee, Chan Joo Kim, In‐Cheol Lee, Sang‐Hak Kang, Seok‐Min Choi, Donghoon Park, Sungha Kario, Kazuomi Association of Morning Hypertension Subtype With Vascular Target Organ Damage and Central Hemodynamics |
title | Association of Morning Hypertension Subtype With Vascular Target Organ Damage and Central Hemodynamics |
title_full | Association of Morning Hypertension Subtype With Vascular Target Organ Damage and Central Hemodynamics |
title_fullStr | Association of Morning Hypertension Subtype With Vascular Target Organ Damage and Central Hemodynamics |
title_full_unstemmed | Association of Morning Hypertension Subtype With Vascular Target Organ Damage and Central Hemodynamics |
title_short | Association of Morning Hypertension Subtype With Vascular Target Organ Damage and Central Hemodynamics |
title_sort | association of morning hypertension subtype with vascular target organ damage and central hemodynamics |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5523792/ https://www.ncbi.nlm.nih.gov/pubmed/28196818 http://dx.doi.org/10.1161/JAHA.116.005424 |
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