| ǥ :
|
ȣ - 530769 260 |
| Determinants of morning hypertension defined by self-measured home blood pressure in treated hypertensive patients: The baseline characteristics and its clinical implications. |
| 충북대학교 의과대학 내과학교실 순환기내과¹ ,고혈압 연구 네트워크² |
| 이주희¹, 배장환¹ ,박정배² ,박창규² ,윤호중² ,최동주²,안영근² ,신준한² ,임세중² ,배장호² ,김동운¹ ² |
Background and objectives; Morning hypertension is the state of blood pressure (BP) elevation during the first 2 hours after waking but not in the evening has been studied using ABPM. There were a few reports advocating morning BP in home BP monitoring is more closely related to target-organ damage or cardiovascular event than evening BP likes in ABPM. Scarce data exists for the baseline characteristics and clinical implications of morning hypertension in treated hypertensive patients in home BP or ambulatory BP monitoring.
Methods; We evaluated 1087 hypertensive patients on anti-hypertensive medication at least for 6 months using self-measured home BP in the morning and evening with multi-center manner. They measured home BPs for 7 days and were checked baseline characteristics and laboratory data. We defined “morning hypertension” as morning-evening systolic or diastolic BP difference is more than 10 mmHg and morning BP is 135/85 mmHg or higher.
Results; There were 173 patients (15.9%) had morning hypertension by definition. They were more male preponderance (n=98, P=0.011), older (P=0.012), more alcohol consumption (P=0.001) and shows higher waist circumference (88.9±8.4cm vs. 87.3±8.4cm, p=0.026) and waist-to-hip ratio (90.2±5.1% vs. 88.9±5.6%, p=0.007) despite of same BMI (25.2±3.0 vs. 25.1±2.9, p=0.512). Laboratory data were comparable in two groups including lipid profiles and there was no difference in DM status, but impaired fasting glucose (IFG) was more prevalent in patients with morning hypertension (36.84% vs. 27.76%, p=0.017). Patients with morning hypertension took more pills (2.11±0.9 vs. 1.96±0.9, p=0.036) and more beta-blockers though there was no statistical significance. They had more cardiovascular risk factor and showed higher BP in clinic and home irrespective of systolic or diastolic period with comparable pulse rate.
Conclusion; Morning hypertension is more likely seen among patients with male gender, older age and alcohol consumption history. It was related to worse clinical variables such as waist circumference, waist-to-hip ratio, IFG and higher BP. So, we can suggest the potential relationship of morning hypertension and poor cardiovascular outcome. Conduction of a large sized longer clinical follow up trial is essential to know the clinical significance of morning hypertension.
|
|
|
|
|
