Premium
UNDERSTANDING THE MORNING RISE IN BLOOD PRESSURE
Author(s) -
Head Geoffrey A,
Lukoshkova Elena V
Publication year - 2008
Publication title -
clinical and experimental pharmacology and physiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 103
eISSN - 1440-1681
pISSN - 0305-1870
DOI - 10.1111/j.1440-1681.2008.04908.x
Subject(s) - morning , blood pressure , medicine , ambulatory blood pressure , stroke (engine) , ambulatory , dosing , circadian rhythm , cardiology , anesthesia , mechanical engineering , engineering
SUMMARY1 The morning period has been recognized as the highest risk period of the day for cardiovascular events, particularly stroke and is also associated with a rapid surge in blood pressure. 2 Evidence now exists to show that the morning surge in blood pressure is an independent risk factor in some elderly hypertensive subjects. 3 However, methods to assess the contribution of the morning blood pressure surge from ambulatory recordings or home recordings, using clock times or times of waking, do not take into consideration the individual patterns of blood pressure change which can range from a rapid rise prior to or following waking to a slow increase over several hours. 4 In the present review we describe a novel method for determining the individual changes using a double logistic equation fitted to the individual pattern of blood pressure change. 5 Methods are presented to determine the rate of rise function over the morning period as well as predicting the change over a fixed time window which may be useful in refining the contribution of the blood pressure surge to cardiovascular risk. 6 Hypertensive people have an exaggerated rise in morning blood pressure as well as a greater rate of rise. 7 Antihypertensive drugs and dosing regimes are being developed which may be useful adjuncts to standard therapy for preventing morning hypertension and hopefully also reducing cardiovascular damage or events.