The relationship between a blunted morning surge and a reversed nocturnal blood pressure dipping or "riser" pattern.
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.
['Fujiwara|Takeshi|T|', 'Tomitani|Naoko|N|', 'Sato|Keiko|K|', 'Okura|Ayako|A|', 'Suzuki|Noriyuki|N|', 'Kario|Kazuomi|K|http://orcid.org/0000-0002-8251-4480']
D000328:Adult D000368:Aged D001794:Blood Pressure D018660:Blood Pressure Monitoring, Ambulatory D002121:Calcium Channel Blockers D002318:Cardiovascular Diseases D002940:Circadian Rhythm D004095:Dihydropyridines D005260:Female D006801:Humans D006973:Hypertension D007022:Hypotension D007564:Japan D008297:Male D008875:Middle Aged D012307:Risk Factors D012890:Sleep
morning surge blood pressure riser extreme dipper nondipper circadian rhythm