Prognostic Value of Morning Blood Pressure Surge in Clinical Events: A Meta-analysis of Longitudinal Studies

Xie, Junchao; Yan, Han; Zhao, Yanxin; Liu, Xueyuan

doi:10.1016/j.jstrokecerebrovasdis.2014.09.001

Cited by 25 publications

(22 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Considering this, it seems logical that the diastolic MSBP, as opposed to the systolic MSBP, is correlated with sympathetic BRS. Previous research concerning the risks associated with the MSBP tends to have involved the use of systolic BP to quantify the morning surge (Xie et al, 2015). As a result, the elevated cardiovascular risk associated with the systolic MSBP has been well established.…”

Section: Discussionmentioning

confidence: 99%

“…However, some participants had morning blood pressure increases that spanned more than 2 h after rising and this is a limitation of the method used. Nonetheless, the risk associated with the pre-awakening morning surge has been more extensively studied (Xie et al, 2015) than definitions that include BP readings over a longer time period after rising, which is why these definitions were not considered in the present study. The BP Power is a promising method as it provides a comprehensive evaluation of an individual's MSBP.…”

Section: Discussionmentioning

confidence: 99%

“…Two widely recognized definitions of the MSBP were quantified for each participant: (i) the pre-awakening morning surge and (ii) the sleep-trough morning surge (Xie et al, 2015). The pre-awakening morning surge was determined via the difference between the average BP recordings 2 h after rising from sleep and the average BP recordings over 2 h before rising from sleep (Figure 1).…”

Section: Methodsmentioning

confidence: 99%

“…Two previous studies have investigated aspects of this relationship. Okada et al (2013) discovered that sympathetic BRS is reduced in elderly, hypertensive individuals with an exaggerated systolic MSBP, defined using the “sleep-trough” method in which morning blood pressures are compared to the trough in blood pressure during sleep (Xie et al, 2015). This method is influenced by dipping status; that is, the extent to which blood pressure decreases during sleep (Yano and Kario, 2012).…”

Section: Introductionmentioning

confidence: 99%

“…Perhaps the most widely used method for quantifying the MSBP is the pre-awakening method. For this method, morning blood pressures are typically compared to those in the 2 or 3-h period prior to waking (Xie et al, 2015) and thus the measure is centered around waking. The aim of this paper is to investigate the relationship between BRS and the MSBP using both the pre-awakening and sleep-trough methods for quantifying the morning surge.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Magnitude of Morning Surge in Blood Pressure Is Associated with Sympathetic but Not Cardiac Baroreflex Sensitivity

et al. 2016

View full text Add to dashboard Cite

The ability of the arterial baroreflex to regulate blood pressure may influence the magnitude of the morning surge in blood pressure (MSBP). The aim was to investigate the relationships between sympathetic and cardiac baroreflex sensitivity (BRS) and the morning surge. Twenty-four hour ambulatory blood pressure was recorded in 14 young individuals. The morning surge was defined via the pre-awakening method, which is calculated as the difference between mean blood pressure values 2 h before and 2 h after rising from sleep. The mean systolic morning surge, diastolic morning surge, and morning surge in mean arterial pressures were 15 ± 2, 13 ± 1, and 11 ± 1 mmHg, respectively. During the laboratory protocol, continuous measurements of blood pressure, heart rate, and muscle sympathetic nerve activity (MSNA) were made over a 10-min period of rest. Sympathetic BRS was quantified by plotting MSNA burst incidence against diastolic pressure (sympathetic BRSinc), and by plotting total MSNA against diastolic pressure (sympathetic BRStotal). Cardiac BRS was quantified using the sequence method. The mean values for sympathetic BRSinc, sympathetic BRStotal and cardiac BRS were −1.26 ± 0.26 bursts/100 hb/mmHg, −1.60 ± 0.37 AU/beat/mmHg, and 13.1 ± 1.5 ms/mmHg respectively. Significant relationships were identified between sympathetic BRSinc and the diastolic morning surge (r = 0.62, p = 0.02) and the morning surge in mean arterial pressure (r = 0.57, p = 0.03). Low sympathetic BRS was associated with a larger morning surge in mean arterial and diastolic blood pressure. Trends for relationships were identified between sympathetic BRStotal and the diastolic morning surge (r = 0.52, p = 0.066) and the morning surge in mean arterial pressure (r = 0.48, p = 0.095) but these did not reach significance. There were no significant relationships between cardiac BRS and the morning surge. These findings indicate that the ability of the baroreflex to buffer increases in blood pressure via reflexive changes in MSNA may play a role in determining the magnitude of the MSBP.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%