Morning surge in blood pressure as a predictor of silent and clinical cerebrovascular disease in elderly hypertensives - A prospective study
Morning surge in blood pressure as a predictor of silent and clinical cerebrovascular disease in elderly hypertensives - A prospective study
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DOI：
10.1161/01.cir.0000056521.67546.aa
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发表时间：
2003-03-18
期刊：
影响因子：
37.8
通讯作者：
Shimada, K
中科院分区：
文献类型：
--
作者：
Kario, K;Pickering, TG;Shimada, K
背景-心血管事件最常发生在早晨。我们前瞻性地研究了老年高血压患者晨间血压激增与卒中的关系。方法和结果-我们对519例老年高血压患者进行动态血压监测，并通过脑MRI评估无症状性脑梗塞，并进行前瞻性随访，研究其卒中预后。晨间血压峰(MS)计算如下：清醒后2小时的平均收缩压减去包括最低睡眠血压在内的1小时的平均收缩压。在平均41个月(从1个月到68个月)期间，发生了44起中风事件。当患者按MS分为两组时，前十位的患者(MS组；MS大于或等于55 mm Hg，n=53)在随访期间多发性脑梗塞的基线患病率(57%比33%，P=0.001)和卒中发生率(19%比7.3%，P=0.004)高于其他组(非MS组；MS组
Background-Cardiovascular events occur most frequently in the morning hours. We prospectively studied the association between the morning blood pressure (BP) surge and stroke in elderly hypertensives.Methods and Results-We studied stroke prognosis in 519 older hypertensives in whom ambulatory BP monitoring was performed and silent cerebral infarct was assessed by brain MRI and who were followed up prospectively. The morning BP surge (MS) was calculated as follows: mean systolic BP during the 2 hours after awakening minus mean systolic BP during the 1 hour that included the lowest sleep BP. During an average duration of 41 months (range 1 to 68 months), 44 stroke events occurred. When the patients were divided into 2 groups according to MS, those in the top decile (MS group; MS greater than or equal to55 mm Hg, n=53) had a higher baseline prevalence of multiple infarcts (57% versus 33%, P=0.001) and a higher stroke incidence (19% versus 7.3%, P=0.004) during the follow-up period than the others (non-MS group; MS