Morning hypertension is a risk factor of macrovascular events following cerebral infarction

Wu, Qinhua; Qu, Jian‐Feng; Yin, Y.; Wang, Aihong; Cheng, Wei; Duan, Ruikang; Zhang, Bin

doi:10.1097/md.0000000000012013

Cited by 8 publications

(7 citation statements)

References 43 publications

(42 reference statements)

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“…In the MoHT group, the multivariable analysis showed that a history of previous cardiovascular disease was the signifcantly independent associated factor. Even though the previous evidence supported that morning hypertension was strongly related to stroke [9,34,35], It could not show the causal efect of cardiovascular disease and MoHT in this study because of the limitation of the cross-sectional design. For EHT and MoEHT groups, the independently associated clinical factor was taking at least 1 long-acting antihypertensive drug once daily in the morning.…”

Section: Discussioncontrasting

confidence: 63%

Prevalence and Clinical Characteristics including Patterns of Antihypertensive Drug Administration of the Different Home Blood Pressure Phenotypes in Treated Hypertensive Patients

Chotruangnapa

Thammarux

Thongdang

2022

International Journal of Hypertension

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Quality and quantity of home blood pressure (BP) control are important for optimizing hypertensive treatment. The prevalence and associated clinical characteristics of the different home blood pressure phenotypes in treated hypertensive patients were not elucidated. This study was conducted in Siriraj Hospital, Thailand from 2019 to 2020. We included treated hypertensive patients with ≥1 antihypertensive drug and had self-home BP measurement data. Both traditional (office BP < 140/90 mmHg and home BP < 130/80 mmHg) and new BP targets (office and home BP < 130/80 mmHg) were used for the classification of BP phenotypes. Home BP phenotypes consisted of controlled hypertension (all home BPs achieved home BP targets), isolated uncontrolled morning hypertension (MoHT) (only morning BP was above home BP targets), isolated uncontrolled evening hypertension (EHT) (only evening BP was above home BP targets), and combined morning-evening uncontrolled hypertension (MoEHT) (all home BPs were above home BP targets). Our study included 1,406 patients. The total mean age was 62.94 ± 13.97 years. There were 39.40% men. The prevalence of each home BP phenotype (by traditional BP target) was 55.76%, 12.66%, 7.40%, and 24.18% in controlled (home) hypertension, MoHT, EHT, and MoEHT, respectively. Classical BP control status was 35.21% well-controlled hypertension, 30.01% white-coat uncontrolled hypertension, 9.74% masked uncontrolled hypertension, and 25.04% sustained uncontrolled hypertension. The multivariable analysis showed the significantly associated factor of MoHT was the presence of previous cardiovascular disease (adjusted OR 5.54, 95% CI (2.02–15.22); p value = 0.001). Taking once-daily long-acting antihypertensive drugs in the morning were significantly associated with both EHT (adjusted OR 0.20, 95% CI (0.05–0.82); p value = 0.025) and MoEHT (adjusted OR 0.20, 95% CI (0.04–1.00); p value = 0.049). These results were consistent in groups classified by new home BP target <130/80 mmHg.

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Section: Discussioncontrasting

confidence: 63%

Prevalence and Clinical Characteristics including Patterns of Antihypertensive Drug Administration of the Different Home Blood Pressure Phenotypes in Treated Hypertensive Patients

Chotruangnapa

Thammarux

Thongdang

2022

International Journal of Hypertension

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“…In this study, the detection rate of dyslipidemia in the high-risk population, lower only than that of hypertension, was 64.5%, indicating the key role of dyslipidemia in increasing the risk of stroke. Studies showed that patients with dyslipidemia were at an increased risk of hemorrhagic stroke (26), and the administration of statins was an independent protective factor against macrovascular events (27). Diabetes is an independent risk factor for stroke, and the stroke exposure rate of people with diabetes is 1.5-3.0 times that of non-diabetic people (28).…”

Section: Discussionmentioning

confidence: 99%

Analysis of the exposure to risk factors for strokes of the high-risk population in Zunyi City, Guizhou Province of China

Lei

et al. 2021

Ann Palliat Med

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“…среди не достигших целевого аД преобладали лица с профилем «Non-dipper», среди достигших -«Dipper», хотя статистически значимой разницы получено не было. Более высокие показатели вУп аД у пациентов, достигших целевого уровня аД, свидетельствуют о его компенсаторном физиологическом нарастании и отражают эффективность терапии [30,31].…”

Section: ðåçóëüòàòûunclassified

Problems of insufficient control of target blood pressure levels in the outpatient practice

Ларина

Fedorova

Михайлусова

et al. 2021

Terapevticheskii arkhiv

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Aim. Assessment of the frequency of reaching the target level of blood pressure (BP) and the factors affecting it in outpatients with arterial hypertension (AH). Materials and methods. An open, one-stage, comparative study involving 64 patients with hypertension and 47 without hypertension at the age of 40 to 59 years. All patients underwent physical examination, assessment of cardiovascular risk (CVR), 24-hour blood pressure monitoring (ABPM), echocardiography (ECHOCG), color duplex scanning of brachiocephalic arteries. Results. Patients with hypertension and comparison groups were comparable in age, sex, smoking, history of myocardial infarction. 1st degree of hypertension was present in 26.6%, 2nd in 40.6%, 3rd in 12.5% of patients. Obesity was detected in 24.3% of patients and all patients with obesity had AH. The SCORE score in individuals with hypertension was 4.94.5; in the comparison group, 2.32.6 (p0.001). Non-stenosing atherosclerosis was present in 54.8% and 88%, p=0.020, and atherosclerotic plaque in the vascular lumen was present in 45.3% and 12% of patients with and without hypertension, respectively (p0.001). 68.8% were constantly treated, and the target BP was reached in 31.3% of patients with hypertension. Male gender (OR 1.68; 95% CI 1.6828.49; p=0.007), obesity (OR 4.78; 95% CI 1.1420.29; p=0.033), concomitant pathology (OR 3.09; 95% CI 1.029.37; p=0.046) were negative, and dyslipidemia (OR 0.10; 95% CI 0.010.84; p=0.033) was positive, affecting the achievement of the target level of blood pressure. Conclusion. The target level of blood pressure was achieved in 31.3% of outpatients with hypertension, mainly in women. Among patients who did not reach the target level of blood pressure, men, individuals with high SSR and obesity predominated. Concomitant pathology and obesity are negative, and dyslipidemia was positively associated with the achievement of the target level of blood pressure, which must be taken into account when developing measures for prevention and treatment.

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Morning hypertension is a risk factor of macrovascular events following cerebral infarction

Cited by 8 publications

References 43 publications

Prevalence and Clinical Characteristics including Patterns of Antihypertensive Drug Administration of the Different Home Blood Pressure Phenotypes in Treated Hypertensive Patients

Prevalence and Clinical Characteristics including Patterns of Antihypertensive Drug Administration of the Different Home Blood Pressure Phenotypes in Treated Hypertensive Patients

Analysis of the exposure to risk factors for strokes of the high-risk population in Zunyi City, Guizhou Province of China

Problems of insufficient control of target blood pressure levels in the outpatient practice

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