title: Morning blood pressure surge is associated with carotid intima-media thickness in prehypertensive patients.
abstract: OBJECTIVE
  Morning blood pressure (BP) surge (MBPS) is defined as an excessive increase in the morning BP from the lowest systolic BP during sleep and is reported as a risk factor for cardiovascular events in current clinical studies. In this study, we aimed to investigate the relationship between MBPS and carotid intima-media thickness (C-IMT) in prehypertensive patients.
  
  
  METHODS
  We evaluated the association between the rate of BP variation derived from ambulatory BP monitoring and C-IMT in patients with prehypertension.
  
  
  RESULTS
  One hundred and seventy patients with prehypertension were included in the study. All office BP measurements and ambulatory 24-h, day-time, and night-time measurements were similar between each group. C-IMT [0.60 (range: 0.57-0.65) vs. 0.55 (range: 0.50-0.60) cm; P<0.001] and the mean platelet volume [8.7 (range: 7.9-9.1) vs. 7.9 (range: 7.3-8.8)  fl; P=0.002] were significantly higher in the greater MBPS group than the lower group. In multivariate analysis, male sex [odds ratio (OR): 2.271, confidence interval (CI): 1.011-5.100, P=0.047], greater MBPS (OR: 8.474, CI: 3.623-19.608, P<0.001), and elevated mean platelet volume levels (OR: 3.359, CI: 1.978-5.705, P<0.001) were found to be independent predictors of greater C-IMT in prehypertensive patients.
  
  
  CONCLUSIONS
  Our study suggests that greater MBPS is associated independently with C-IMT in prehypertensive patients.
authors.affiliation: aDepartment of Cardiology, Konya Training and Research Hospital bDepartment of Internal Medicine and Cardiology, Baskent University Konya Training and Research Center, Konya cDepartment of Cardiology, İstanbul Medeniyet University, Istanbul dDepartment of Internal Medicine and Cardiology, Baskent University Ankara Training and Research Center, Ankara, Turkey.
authors.forename: Sertac
authors.initials: S
authors.lastname: Alpaydin
authors.forename: Yasar
authors.initials: Y
authors.lastname: Turan
authors.forename: Mustafa
authors.initials: M
authors.lastname: Caliskan
authors.forename: Zuhal
authors.initials: Z
authors.lastname: Caliskan
authors.forename: Feyza
authors.initials: F
authors.lastname: Aksu
authors.forename: Serhan
authors.initials: S
authors.lastname: Ozyildirim
authors.forename: Zafer
authors.initials: Z
authors.lastname: Buyukterzi
authors.forename: Osman
authors.initials: O
authors.lastname: Kostek
authors.forename: Haldun
authors.initials: H
authors.lastname: Muderrisoglu
mesh_terms: D000328:Adult; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D059168:Carotid Intima-Media Thickness; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D063847:Mean Platelet Volume; D008875:Middle Aged