The Association between Morning Blood Pressure Surge and Carotid Atherosclerosis in Patients with Essential Hypertension

Objective To investigate the association between morning blood pressure surge(MBPS) and carotid atherosclerosis in patients with essential hypertension.Methods According to the results of 24 h ambulatory blood pressure monitoring,137 patients were classified as the morning BP surge group(MBPS group,n=75),and non-surge group(NMBPS group,n=62).Patients underwent carotid ultrasound and the intima-medial thickness(CCA-IMT) and plaques were examined.Results ① The CCA-IMT of the MBPS group was significantly thicker than that the NMBPS group [CCA-IMT,MBPS group(1.34±0.13) mm vs NMBPS group(0.98±0.43) mm,P0.05];② Pearson relation analysis showed that CCA-IMT level positively correlated with age(r=0.276,P=0.001),the average of 24 h SBP(r=0.344,P0.01),FPG(r=0.431,P0.01),LDL(r=0.333,P0.01) and MBPS(r=0.822,P0.01);③ After adjusting for age,duration,BMI,24 h SBP,24 h DBP,blood glucose,lipid profiles,multiple regression analysis showed that MBPS and LDL remained as predisposing risk factors for CCA-IMT levels;④ Compared with the NMBPS group,the severity of carotid arteries plaque of the MBPS group was significantly higher [mean rank order,MBPS group: 78.25 vs NMBPS group: 57.81,P0.01].Conclusion The study showed that MBPS was closely related with carotid atherosclerosis in patients with essential hypertension suggesting it is justified for concurrent inhibition of morning BP surge in the treatment of high blood pressure.