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Background and ObjectivesThe early morning blood pressure surge (EMBPS) has been reported to be associated with cardiovascular events. The aim of this study was to investigate the relationship between 24-hour ambulatory BP monitoring (ABPM) parameters and conventional cardiovascular risk factors.Subjects and MethodsPatients (n=346) never-treated for essential hypertension with no other cardiovascular risk factors, such as diabetes, dyslipidemia, and nephropathy were enrolled. The EMBPS was defined as the early morning systolic BP minus the lowest night systolic BP. We compared the 24-hour ABPM parameters in two groups divided by age (<60 and ≥60 years) and examined the association between the 24-hour ABPM parameters and cardiovascular risk factor.ResultsThe EMBPS (18±14 vs. 24±14 mmHg, p=0.002), 24-hour mean blood pressure {MBP; 102±9 vs. 105±11 mmHg, p=0.044}, and 24-hour mean pulse pressure (PP; 52±10 vs. 58±11 mmHg, p<0.001) were significantly increased in the elderly subjects compared to the younger subjects. The degree of decrease was less in the elderly subjects (10±8 vs. 7±10%, p=0.002). Based on multivariate analysis, age was an independent risk factor for the highest quartile of EMBPS (>28 mmHg) after adjusting for gender differences, body mass index, and various 24-hour ABPM parameters (odds ratio, 1.051; 95% confidence interval, 1.028-1.075; p<0.001).ConclusionAge is an independent risk factor for EMBPS in patients with never-treated hypertension. BP control in the early morning period is more important in elderly patients so as to prevent cardiovascular events.

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An identity management including authentication and authorization in a network environment is a critical security factor. Various models for identity management have been developed continually, from the silo model to the federated model and to the recently introduced self-sovereign identity (SSI) model. In particular, SSI makes users manage their own information by themselves independently of any organizations. SSI utilizes the newly emerged blockchain technology and many studies of it are in progress. However, SSI has not had wide public use because of its low compatibility and inconvenience. This is because it involves an unfamiliar user experience and an immature process. To solve this problem, this paper proposes a new blockchain-based SSI model that complies with the popular and mature standard of OAuth 2.0. Using blockchain, the proposed model secures users’ data sovereignty where users can use and control their own information in a decentralized manner, instead of depending on a specific monopolistic service-providers. Users and clients who are familiar with the existing OAuth can easily accept the proposed model and apply it, which makes both usability and scalability of the model excellent. This paper confirmed the feasibility of the proposed model by implementing it and a security analysis was performed. The proposed model is expected to contribute to the expansion of both blockchain technology and SSI.