UCL logo

UCL Discovery

UCL home » Library Services » Electronic resources » UCL Discovery

Prognostic value of the morning blood pressure surge in 5645 subjects from 8 populations.

Li, Y; Thijs, L; Hansen, TW; Kikuya, M; Boggia, J; Richart, T; Metoki, H; ... International Database on Ambulatory Blood Pressure Monitoring i, ; + view all (2010) Prognostic value of the morning blood pressure surge in 5645 subjects from 8 populations. Hypertension , 55 (4) pp. 1040-1048. 10.1161/HYPERTENSIONAHA.109.137273.

Full text not available from this repository.

Abstract

Previous studies on the prognostic significance of the morning blood pressure surge (MS) produced inconsistent results. Using the International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcome, we analyzed 5645 subjects (mean age: 53.0 years; 54.0% women) randomly recruited in 8 countries. The sleep-through and the preawakening MS were the differences in the morning blood pressure with the lowest nighttime blood pressure and the preawakening blood pressure, respectively. We computed multivariable-adjusted hazard ratios comparing the risk in ethnic- and sex-specific deciles of the MS relative to the average risk in the whole study population. During follow-up (median: 11.4 years), 785 deaths and 611 fatal and nonfatal cardiovascular events occurred. While accounting for covariables and the night:day ratio of systolic pressure, the hazard ratio of all-cause mortality was 1.32 (95% CI: 1.09 to 1.59; P=0.004) in the top decile of the systolic sleep-through MS (>or=37.0 mm Hg). For cardiovascular and noncardiovascular death, these hazard ratios were 1.18 (95% CI: 0.87 to 1.61; P=0.30) and 1.42 (95% CI: 1.11 to 1.80; P=0.005). For all cardiovascular, cardiac, coronary, and cerebrovascular events, the hazard ratios in the top decile of the systolic sleep-through MS were 1.30 (95% CI: 1.06 to 1.60; P=0.01), 1.52 (95% CI: 1.15 to 2.00; P=0.004), 1.45 (95% CI: 1.04 to 2.03; P=0.03), and 0.95 (95% CI: 0.68 to 1.32; P=0.74), respectively. Analysis of the preawakening systolic MS and the diastolic MS generated consistent results. In conclusion, a MS above the 90th percentile significantly and independently predicted cardiovascular outcome and might contribute to risk stratification by ambulatory blood pressure monitoring.

Type: Article
Title: Prognostic value of the morning blood pressure surge in 5645 subjects from 8 populations.
Location: United States
DOI: 10.1161/HYPERTENSIONAHA.109.137273
Keywords: Blood Pressure, Blood Pressure Monitoring, Ambulatory, Cardiovascular Diseases, Circadian Rhythm, Databases, Factual, Female, Humans, Incidence, Male, Middle Aged, Prognosis, Risk Factors, Surveys and Questionnaires
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Cardiovascular Science
URI: http://discovery.ucl.ac.uk/id/eprint/1428779
Downloads since deposit
0Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item