Morning blood pressure surge and blood pressure variability in young and middle-aged essential hypertensive patients

Objective To investigate the association between morning blood pressure surge and blood pressure variability in young and middle-aged essential hypertensive patients. Methods Between November 2011 and January 2015, in the ward of hypertension in Peking University People′s Hospital, a total of 160 young and middle-aged essential hypertensive patients who were never treated or didn′t receive medical treatment in recently four weeks underwent 24 h ambulatory blood pressure monitoring and ambulatory electrocardiogram recording.All patients were divided into the MBPS group, which was defined as having the highest quartile of morning BP increase from sleep(≥28.67 mmHg; n=44)and the non-MBPS group(<28.67 mmHg; n=116). And then we compared all indexes between these two groups. Results Compared with patients in non-MBPS group, those in MBPS group had higher 24 h SBP variability(24 h-SBP-BPV), 24 hours diastolic blood pressure(DBP)variability(24 h-DBP-BPV), nighttime SBP variability(n-SBP-BPV)and nighttime DBP variability(n-DBP-BPV). And their correlation coefficients with MBPS were 0.325, 0.315, 0.316 and 0.286 respectively(all P<0.001). After adjustments for factors associated with MBPS[such as 24 hours mean systolic blood pressure(24 h-SBP), daytime mean systolic blood pressure(d-SBP)profile and the circadian BP pattern]these correlations still existed significantly, except for n-DBP-BPV, OR are respectively 2.43(1.06-5.59), 2.23(1.16-4.30), 1.32(1.06-1.64). Conclusions In young and middle-aged essential hypertensive patients, the day-night SBP dipping, 24 h-BPV and n-BPV have significant association with MBPS.Compared with DBP-BPV, SBP-BPV are more correlated with MBPS.Moreover, 24 h-SBP, d-SBP and MHRS also have an effect on MBPS to some extent. Key words: Hypertension; Morning blood pressure surge; Blood pressure variability; Ambulatory blood pressure monitoring; Ambulatory electrocardiogram recording