Relationship between morning hypertension identified by home blood pressure monitoring and brain natriuretic peptide and estimated glomerular filtration rate: the Japan Morning Surge 1 (JMS-1) Study.
We evaluated whether morning minus evening systolic blood pressure (SBP) difference (MEdif) in home blood pressure measurements can be a marker for hypertensive target organ damage. The authors analyzed 611 hypertensive patients who had high morning SBP levels (>/=135 mm Hg). The patients with morning hypertension (MEdif >/=15 mm Hg, average of morning and evening SBP [MEave] >/=135 mm Hg) were older (P<.001) and had a longer duration of hypertension and antihypertensive medication use, a higher prevalence of left ventricular hypertrophy (LVH) on electrocardiography, a lower glomerular filtration rate by the Cockcroft-Gault equation (P=.002), and a higher brain natriuretic peptide (BNP) level (P<.001) than those with well-controlled blood pressure (MEdif <15 mm Hg, MEave <135 mm Hg). The patients with morning hypertension had a higher BNP level than those with well-controlled blood pressure after adjustment for the confounding factors (28.7 pg/mL vs 20.0 pg/mL; P=.033). In conclusion, morning hypertension is more likely seen among patients with older age and longer duration of hypertension and antihypertensive medication use, and it may be associated with a higher prevalence of LVH and a higher BNP level.
Ishikawa
Joji
J
Division of Cardiovascular Medicine, Department of Internal Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
Hoshide
Satoshi
S
Shibasaki
Seiichi
S
Matsui
Yoshio
Y
Kabutoya
Tomoyuki
T
Eguchi
Kazuo
K
Ishikawa
Shizukiyo
S
Pickering
Thomas G
TG
Shimada
Kazuyuki
K
Kario
Kazuomi
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018660:Blood Pressure Monitoring, Ambulatory; D002940:Circadian Rhythm / Q000502:physiology*; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D013599:Systole / Q000502:physiology
D020097:Natriuretic Peptide, Brain