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

Yan Li; Lutgarde Thijs; Tine W Hansen; Masahiro Kikuya; José Boggia; Tom Richart; Hirohito Metoki; Takayoshi Ohkubo; Christian Torp-Pedersen; Tatiana Kuznetsova; Katarzyna Stolarz-Skrzypek; Valérie Tikhonoff; Sofia Malyutina; Edoardo Casiglia; Yuri Nikitin; Edgardo Sandoya; Kalina Kawecka-Jaszcz; Hans Ibsen; Yutaka Imai; Jiguang Wang; Jan A Staessen; International Database on Ambulatory Blood Pressure Monitoring in Relation to Cardiovascular Outcomes Investigators; Yan Li

doi:http://dx.doi.org/10.1161/HYPERTENSIONAHA.109.137273

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

Yan Li, Lutgarde Thijs, Tine W Hansen, Masahiro Kikuya, José Boggia, Tom Richart, Hirohito Metoki, Takayoshi Ohkubo, Christian Torp-Pedersen, Tatiana Kuznetsova, Katarzyna Stolarz-Skrzypek, Valérie Tikhonoff, Sofia Malyutina, Edoardo Casiglia, Yuri Nikitin, Edgardo Sandoya, Kalina Kawecka-Jaszcz, Hans Ibsen, Yutaka Imai, Jiguang WangJan A Staessen, International Database on Ambulatory Blood Pressure Monitoring in Relation to Cardiovascular Outcomes Investigators, Yan Li

191 Citations (Scopus)

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 (^ge;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.

Original language	English
Journal	Hypertension
Volume	55
Issue number	4
Pages (from-to)	1040-8
Number of pages	9
DOIs	https://doi.org/10.1161/HYPERTENSIONAHA.109.137273
Publication status	Published - 1 Apr 2010

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Li, Y., Thijs, L., Hansen, T. W., Kikuya, M., Boggia, J., Richart, T., Metoki, H., Ohkubo, T., Torp-Pedersen, C., Kuznetsova, T., Stolarz-Skrzypek, K., Tikhonoff, V., Malyutina, S., Casiglia, E., Nikitin, Y., Sandoya, E., Kawecka-Jaszcz, K., Ibsen, H., Imai, Y., ... Li, Y. (2010). Prognostic value of the morning blood pressure surge in 5645 subjects from 8 populations. Hypertension, 55(4), 1040-8. https://doi.org/10.1161/HYPERTENSIONAHA.109.137273

Li, Y, Thijs, L, Hansen, TW, Kikuya, M, Boggia, J, Richart, T, Metoki, H, Ohkubo, T, Torp-Pedersen, C, Kuznetsova, T, Stolarz-Skrzypek, K, Tikhonoff, V, Malyutina, S, Casiglia, E, Nikitin, Y, Sandoya, E, Kawecka-Jaszcz, K, Ibsen, H, Imai, Y, Wang, J, Staessen, JA, International Database on Ambulatory Blood Pressure Monitoring in Relation to Cardiovascular Outcomes Investigators & Li, Y 2010, 'Prognostic value of the morning blood pressure surge in 5645 subjects from 8 populations', Hypertension, vol. 55, no. 4, pp. 1040-8. https://doi.org/10.1161/HYPERTENSIONAHA.109.137273

@article{25a60e9f79c0476a91a9db820fd723f2,

title = "Prognostic value of the morning blood pressure surge in 5645 subjects from 8 populations",

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 (^ge;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.",

author = "Yan Li and Lutgarde Thijs and Hansen, {Tine W} and Masahiro Kikuya and Jos{\'e} Boggia and Tom Richart and Hirohito Metoki and Takayoshi Ohkubo and Christian Torp-Pedersen and Tatiana Kuznetsova and Katarzyna Stolarz-Skrzypek and Val{\'e}rie Tikhonoff and Sofia Malyutina and Edoardo Casiglia and Yuri Nikitin and Edgardo Sandoya and Kalina Kawecka-Jaszcz and Hans Ibsen and Yutaka Imai and Jiguang Wang and Staessen, {Jan A} and Torp-Pedersen, {Christian Tobias} and Yan Li",

year = "2010",

month = apr,

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doi = "http://dx.doi.org/10.1161/HYPERTENSIONAHA.109.137273",

language = "English",

volume = "55",

pages = "1040--8",

journal = "Hypertension",

issn = "0194-911X",

publisher = "Lippincott Williams & Wilkins",

number = "4",

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TY - JOUR

T1 - Prognostic value of the morning blood pressure surge in 5645 subjects from 8 populations

AU - Li, Yan

AU - Thijs, Lutgarde

AU - Hansen, Tine W

AU - Kikuya, Masahiro

AU - Boggia, José

AU - Richart, Tom

AU - Metoki, Hirohito

AU - Ohkubo, Takayoshi

AU - Torp-Pedersen, Christian

AU - Kuznetsova, Tatiana

AU - Stolarz-Skrzypek, Katarzyna

AU - Tikhonoff, Valérie

AU - Malyutina, Sofia

AU - Casiglia, Edoardo

AU - Nikitin, Yuri

AU - Sandoya, Edgardo

AU - Kawecka-Jaszcz, Kalina

AU - Ibsen, Hans

AU - Imai, Yutaka

AU - Wang, Jiguang

AU - Staessen, Jan A

AU - International Database on Ambulatory Blood Pressure Monitoring in Relation to Cardiovascular Outcomes Investigators

AU - Li, Yan

PY - 2010/4/1

Y1 - 2010/4/1

N2 - 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 (^ge;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.

AB - 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 (^ge;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.

U2 - http://dx.doi.org/10.1161/HYPERTENSIONAHA.109.137273

DO - http://dx.doi.org/10.1161/HYPERTENSIONAHA.109.137273

M3 - Journal article

SN - 0194-911X

VL - 55

SP - 1040

EP - 1048

JO - Hypertension

JF - Hypertension

IS - 4

ER -

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

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