Age is an Independent Risk Factor for the Early Morning Blood Pressure Surge in Patients Never-Treated for Hypertension.
OBJECTIVE
The early morning blood pressure surge (EMBPS) has been reported to be associated with cardiovascular events. The aim of this study was to investigate the relationship between 24-hour ambulatory BP monitoring (ABPM) parameters and conventional cardiovascular risk factors.


METHODS
Patients (n=346) never-treated for essential hypertension with no other cardiovascular risk factors, such as diabetes, dyslipidemia, and nephropathy were enrolled. The EMBPS was defined as the early morning systolic BP minus the lowest night systolic BP. We compared the 24-hour ABPM parameters in two groups divided by age (<60 and >/=60 years) and examined the association between the 24-hour ABPM parameters and cardiovascular risk factor.


RESULTS
The EMBPS (18+/-14 vs. 24+/-14 mmHg, p=0.002), 24-hour mean blood pressure {MBP; 102+/-9 vs. 105+/-11 mmHg, p=0.044}, and 24-hour mean pulse pressure (PP; 52+/-10 vs. 58+/-11 mmHg, p<0.001) were significantly increased in the elderly subjects compared to the younger subjects. The degree of decrease was less in the elderly subjects (10+/-8 vs. 7+/-10%, p=0.002). Based on multivariate analysis, age was an independent risk factor for the highest quartile of EMBPS (>28 mmHg) after adjusting for gender differences, body mass index, and various 24-hour ABPM parameters (odds ratio, 1.051; 95% confidence interval, 1.028-1.075; p<0.001).


CONCLUSIONS
Age is an independent risk factor for EMBPS in patients with never-treated hypertension. BP control in the early morning period is more important in elderly patients so as to prevent cardiovascular events.
Lee
Dong-Hyeon
DH
Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Ihm
Sang-Hyun
SH
Youn
Ho-Joong
HJ
Choi
Yun-Seok
YS
Park
Chan-Seok
CS
Park
Chul-Soo
CS
Lee
Jong-Min
JM
Kim
Hee-Youl
HY
Oh
Yong-Seog
YS
Chung
Wook-Sung
WS
Seung
Ki-Bae
KB
Kim
Jae-Hyung
JH