Management of morning hypertension: a consensus statement of an Asian expert panel

Abstract

Morning blood pressure (BP) surge is an important aspect of hypertension research.Morning BP monitoring could be a clinically relevant concept in the therapeutic man-

Home blood pressure control status in 2017‐2018 for hypertension specialist centers in Asia: Results of the Asia BP@Home study

“…[47][48][49][50] Lifestyle factors in Asia mean that evening BP is difficult to measure before dinner at home, and evening home BP measured at bedtime after dinner is significantly affected by alcohol consumption and bathing, 51 making this approach much less reliable, as has been shown previously. For Asian patients, we recommend measurement of morning BP before taking medication as the first target of a hypertension management strategy.…”

Morning hypertension in Asian populations

“…Also, stroke is more prevalent in Asia compared with all other geographical regions, and incident episodes are mostly distributed in the early morning hours . Under these considerations, this statement on the management of morning hypertension in Asia might have important healthcare consequences.…”

“…The Consensus Statement of an Asian Expert Panel presented in this issue of the Journal of Clinical Hypertension focused on the management of morning hypertension may stimulate further research in the field and promote the concept that this phenotype of hypertension can be a complementary clinical tool for decision‐making . Some of the authors of this Asian Expert Panel extensively reviewed this topic elsewhere a few months ago …”

Could 130/80 mm Hg Be Adopted as the Diagnostic Threshold and Management Goal of Hypertension in Consideration of the Characteristics of Asian Populations?

“…Specifically, we have focused on a morning home BP-guided approach as the most effective strategy to achieve zero cardiovascular events in Asia. [27][28][29][30] The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2014) first documented a home BP-guided approach as the most effective practical approach in clinical practice. 31 The 2017 ACC/AHA guidelines recommended home BP monitoring for confirmation of the diagnosis of hypertension and for titration of BP-lowering medication, in conjunction with telehealth counseling (recommendation: Class I; Level of Evidence A).…”

“…[27][28][29][30] We stressed the importance of morning home BP in clinical practice [27][28][29][30] because morning home BP has shown better reproducibility than evening home BP or clinic BP. 36 However, the measurement of evening home BP just before going to bed is strongly affected by the individual's dinner (including alcohol consumption) and evening behavior (eg, bathing in the evening is common in Asia).…”