Characterisation of the morning surge of blood pressure as a risk factor for cardiovascular disease.

心血管事件在清晨睡眠和清醒状态之间的转换中发生得更频繁。这与血压和心率上升达到最大值的时期平行，因此可能是心血管事件的潜在危险标志。我们开发了一种新的数学方法，使用动态监测来测量患者早上的血压和心率激增，该方法已获专利。这笔赠款的主要目的是确定晨间血压激增是否是一个危险因素，并确定潜在的机制。利用临床和实验研究，我们的目标是a)表征高血压和正常血压的晨起速率，b)确定血压早晨激增的受试者是否也有过度反应的神经系统，c)确定血压上升的速率是否是一个危险因素，以及d)确定在容易中风的动物中，防止清醒的血压激增是否有益。这将通过一种新的分析方法实现，即在24小时内连续记录BP。这些研究很重要，因为确定新的心脏性猝死、中风和心肌梗死的危险标志物或预测因素是国家健康的优先事项。了解导致早晨心血管事件风险增加的机制是设计适当治疗和风险管理的第一步。我们的研究将从机制和治疗两个方面阐明这一点。

Cardiovascular events occur more frequently in the early morning transition between the asleep and awake state. This parallels the period where the rise in blood pressure and heart rate is at its greatest and hence may be a potential risk marker for cardiovascular events. We have developed a new mathematical way of measuring the morning surge in blood pressure and heart rate in patients using ambulatory monitoring which has been patented. The main aim of the grant is to determine if morning blood pressure surge is a risk factor and to determine the underlying mechanisms. Using both clinical and experimental studies we aim to a) characterise the rate of morning rise in hypertension and normotension b) determine whether subjects with an exaggerated morning surge in blood pressure also have an over responsive nervous system, c) determine whether the rate of rise in blood pressure is a risk factor and d) determine in stroke prone animals whether preventing the waking blood pressure surge is beneficial. This will be achieved via a novel analysis method of continuous BP recording over the 24hr period. These studies are important since identification of new risk markers or predictors of sudden cardiac death, stroke and myocardial infarction is a national health priority. Understanding the mechanisms that are responsible for the increased risk of a cardiovascular event in the morning is the first step to devising appropriate treatment and risk management. Our study will shed light on both the mechanism and the therapy aspects.