P-135: Morning rise in blood pressure associates with hypertensive cardiovascular complications:

Abstract

Blood pressure rise in early morning is considered an important risk factor for vascular complications of hypertension. We examined the characteristics of hypertensive patients who have a blood pressure rise in the morning judged by self-measurement of blood pressure at home concerning to the hypertensive cardiovascular complications. The subjects enrolled in this study were 218 untreated hypertensive patients (132 men and 86 women, mean age; 55.2±11.2 years). Subjects were instructed by nursing stuffs how to measure their own blood pressures at home. Monitor used in this study was cuff-oscillometric device (Omron HEM-737, Omron, Tokyo), which was checked by connecting to the sphygmomanometer with a Y-connector at monthly clinic visits. Subjects were asked to measure their home blood pressure in the morning within 30 min after awakening and in the evening just before going to bed. Subjects were divided to two groups according to the difference of systolic blood pressure (SBP) between morning and evening (M-SBP-E-SBP); morning rise group (MR) = M-SBP-E-SBP ≥10 mmHg (n=61) and non-morning rise group (NMR) = M-SBP-E-SBP<±10 mmHg (n=157). Two-dimension guided M-mode echocardiograms of left ventricle were recorded. End-systolic and end-diastolic measurements of left ventricular internal dimension, interventricular septal thickness, and left ventricular posterior wall thickness were made according to the American Society of Echocardiography recommendations. Left ventricular mass index was calculated using the formula introduced by Devereux et al. End-diastolic relative wall thickness was calculated as the ratio of posterior wall thickness to one-half left ventricular internal dimension. MR group was more common in men (36.4% vs 15.1%, p=0.001). MR subjects had increased end-diastolic relative wall thickness (0.453±0.066 vs 0.428±0.059, p=0.008), left ventricular mass index (130±25 vs 100±15 g/m², p<0.001), serum creatinine (Cr, 0.78±0.18 vs 0.73±0.16 mg/dl, p=0.027) and urinary protein excretion (100±165 vs 34±48 mg/g Cr, p=0.007) compared to NMR ones. It can be concluded that the hypertensive patients with a morning rise in blood pressure have advanced hypertensive cardiovascular complications.

Morning rise in blood pressure, cardiac hypethrophy, home blood pressure