Korean Circ J.  2011 Dec;41(12):733-743. 10.4070/kcj.2011.41.12.733.

Morning Hypertension in Treated Hypertensives: Baseline Characteristics and Clinical Implications

• Lee JH
• Bae JW
• Park JB
• Park CG
• Youn HJ
• Choi DJ
• Ahn YK
• Shin JH
• Rim SJ
• Bae JH
• Kim DW

• KMID: 1776249
• DOI: http://doi.org/10.4070/kcj.2011.41.12.733

Abstract

BACKGROUND AND OBJECTIVES
Morning hypertension is closely related to target organ damage and cardiovascular events. Little data is available concerning the baseline characteristics and comprehensive blood pressure analysis of hypertensive patients on treatment with morning hypertension.
SUBJECTS AND METHODS
We evaluated 1,087 hypertensive patients who had taken stable anti-hypertensive medication at least 6 months. The enrolled patients measured their home blood pressure for 7 days. Baseline characteristics and the laboratory data were analyzed. Morning hypertension was defined as a morning blood pressure > or =135/85 mm Hg and systolic or diastolic blood pressure difference between morning and evening exceeding 10 mm Hg.
RESULTS
One hundred seventy three patients with morning hypertension showed a preponderance of males, older patients, alcohol consumers, and greater waist circumference and waist-to-hip ratio despite the same body mass index. Impaired fasting glucose and metabolic syndrome were more prevalent in the patients with morning hypertension. The morning hypertensives took more anti-hypertensive drugs and displayed higher blood pressure in the clinic and at home.
CONCLUSION
The worse clinical variables and relatively poorly controlled blood pressure of those with morning hypertension supports a potential relationship of morning hypertension with poor cardiovascular outcome. Morning blood pressure should be monitored at home for the optimal treatment of hypertension.

Keyword

Home Blood Pressure Monitoring

MeSH Terms

Antihypertensive Agents
Blood Pressure
Blood Pressure Monitoring, Ambulatory
Body Mass Index
Fasting
Glucose
Humans
Hypertension
Male
Waist Circumference
Waist-Hip Ratio
Antihypertensive Agents
Glucose

Figure

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  Fig. 1 The number of metabolic components in patients with morning hypertension showed increasing tendency (p=0.049). *The peak incidence in morning hypertensives was higher.

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  Fig. 2 The distribution of hypertensive patients is significantly different. A: the patients with morning hypertension showed higher prevalence of uncontrolled hypertension and masked hypertension and lower prevalence of controlled hypertension compared with the patients without morning hypertension. B: morning hypertension occupying much higher proportion in masked hypertension and uncontrolled hypertension. C: in the patients with masked hypertension or uncontrolled hypertension, there was a tendency to have high morning blood pressure. HT: hypertension.

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