The relationship between a blunted morning surge and a reversed nocturnal blood pressure dipping or “riser” pattern

Takeshi Fujiwara, Naoko Tomitani, Keiko Sato, Ayako Okura, Noriyuki Suzuki, Kazuomi Kario

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

The authors sought to determine the association between the blunted morning blood pressure (BP) surge and nocturnal BP dipping of the “riser” pattern in 501 patients with hypertension enrolled in the ACHIEVE-ONE (Ambulatory Blood Pressure Control and Home Blood Pressure [Morning and Evening] Lowering by the N-Channel Blocker Cilnidipine) trial. The patients' sleep-trough morning BP surge and prewaking surge were calculated and then classified according to their nocturnal systolic BP reduction pattern as extreme dippers, dippers, nondippers, and risers. The prevalence of the riser pattern was significantly higher in both the lowest sleep-trough morning BP surge decile and the prewaking surge decile (blunted surge group) compared with the remaining deciles (56.0% vs 10.4% [P<.0001] and 59.2% vs 10.2% [P<.0001], respectively). The riser pattern was a significant determinant of both blunted sleep-trough morning BP surge (odds ratio, 73.3; P<.0001) and blunted prewaking surge (odds ratio, 14.8; P<.0001). The high prevalence of the riser pattern in patients with blunted morning BP surges may account for the cardiovascular risk previously reported in such patients.

Original languageEnglish
Pages (from-to)1108-1114
Number of pages7
JournalJournal of Clinical Hypertension
Volume19
Issue number11
DOIs
StatePublished - Nov 2017
Externally publishedYes

Keywords

  • blood pressure
  • circadian rhythm
  • extreme dipper
  • morning surge
  • nondipper
  • riser

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