Moderate morning rise in blood pressure has lowest risk of stroke but only in women
Background:The morning period which is recognized as the highest risk for cardiovascular events is associated with a surge in blood pressure (BP). However, it is unclear what aspect of this rise is important.Aim:To determine whether the rate of rise (RoR), the magnitude (day night difference) or the...
| Main Authors: | , , , , , , , |
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| Format: | Journal Article |
| Language: | English |
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LIPPINCOTT WILLIAMS & WILKINS
2019
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| Subjects: | |
| Online Access: | http://purl.org/au-research/grants/nhmrc/317826 http://hdl.handle.net/20.500.11937/93778 |
| _version_ | 1848765787497562112 |
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| author | Head, G.A. Sata, Y. Imai, Y. Kikuya, M. Ohkubo, T. Reid, Christopher McGrath, B.M. Lukoshkova, E.V. |
| author_facet | Head, G.A. Sata, Y. Imai, Y. Kikuya, M. Ohkubo, T. Reid, Christopher McGrath, B.M. Lukoshkova, E.V. |
| author_sort | Head, G.A. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Background:The morning period which is recognized as the highest risk for cardiovascular events is associated with a surge in blood pressure (BP). However, it is unclear what aspect of this rise is important.Aim:To determine whether the rate of rise (RoR), the magnitude (day night difference) or the product [BP power (BPPower)] is associated with increased cardiovascular risk.Methods:We developed a logistic equation method to fit individual 24-h patterns of BP to determine RoR, amplitude and BPPower using the ambulatory recordings from the Ohasama study including 564 men and 971 women (16.6 years follow-up).Results:Men had a higher risk of cardiovascular events than women (24, 16%, P < 0.001). Age and night BP were strong linear risk predictors. In men sorting risk by quintiles of BPPower (adjusted for age, night BP, smoking status) revealed no clear linear or nonlinear pattern. However, in women BPPower had a U-shaped relationship with the lowest risk being the 2-3rd quintile for all cardiovascular events (Pquadratic = 0.01) including cardiovascular death (Pquadratic = 0.03) and nonfatal stroke (Pquadratic = 0.02). A similar but less clear trend was observed with the RoR but only stroke (infarct) reached significance (Pquadratic = 0.03) while sorting by range showed a U shaped pattern for combined cardiovascular events (Pquadratic = 0.04).Conclusion:These findings suggest that the morning BPPower is an important independent risk factor for predicting cardiovascular events and stroke but only in women with median levels having the lowest risk. |
| first_indexed | 2025-11-14T11:40:48Z |
| format | Journal Article |
| id | curtin-20.500.11937-93778 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T11:40:48Z |
| publishDate | 2019 |
| publisher | LIPPINCOTT WILLIAMS & WILKINS |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-937782023-12-21T03:15:53Z Moderate morning rise in blood pressure has lowest risk of stroke but only in women Head, G.A. Sata, Y. Imai, Y. Kikuya, M. Ohkubo, T. Reid, Christopher McGrath, B.M. Lukoshkova, E.V. Science & Technology Life Sciences & Biomedicine Peripheral Vascular Disease Cardiovascular System & Cardiology ambulatory blood pressure blood pressure cardiovascular risk circadian rhythm women hypertension logistic equation men stroke DOUBLE-LOGISTIC ANALYSIS PROGNOSTIC-SIGNIFICANCE SURGE HYPERTENSION SILENT ASSOCIATION ACTIVATION PREDICTION MORTALITY INCREASE Adult Age Factors Aged Blood Pressure Blood Pressure Monitoring, Ambulatory Circadian Rhythm Female Humans Hypertension Male Middle Aged Risk Factors Sex Factors Stroke Humans Hypertension Blood Pressure Monitoring, Ambulatory Risk Factors Age Factors Sex Factors Circadian Rhythm Blood Pressure Adult Aged Middle Aged Female Male Stroke Background:The morning period which is recognized as the highest risk for cardiovascular events is associated with a surge in blood pressure (BP). However, it is unclear what aspect of this rise is important.Aim:To determine whether the rate of rise (RoR), the magnitude (day night difference) or the product [BP power (BPPower)] is associated with increased cardiovascular risk.Methods:We developed a logistic equation method to fit individual 24-h patterns of BP to determine RoR, amplitude and BPPower using the ambulatory recordings from the Ohasama study including 564 men and 971 women (16.6 years follow-up).Results:Men had a higher risk of cardiovascular events than women (24, 16%, P < 0.001). Age and night BP were strong linear risk predictors. In men sorting risk by quintiles of BPPower (adjusted for age, night BP, smoking status) revealed no clear linear or nonlinear pattern. However, in women BPPower had a U-shaped relationship with the lowest risk being the 2-3rd quintile for all cardiovascular events (Pquadratic = 0.01) including cardiovascular death (Pquadratic = 0.03) and nonfatal stroke (Pquadratic = 0.02). A similar but less clear trend was observed with the RoR but only stroke (infarct) reached significance (Pquadratic = 0.03) while sorting by range showed a U shaped pattern for combined cardiovascular events (Pquadratic = 0.04).Conclusion:These findings suggest that the morning BPPower is an important independent risk factor for predicting cardiovascular events and stroke but only in women with median levels having the lowest risk. 2019 Journal Article http://hdl.handle.net/20.500.11937/93778 10.1097/HJH.0000000000002027 English http://purl.org/au-research/grants/nhmrc/317826 http://purl.org/au-research/grants/nhmrc/1049610 http://purl.org/au-research/grants/nhmrc/1092642 http://purl.org/au-research/grants/nhmrc/1136372 http://purl.org/au-research/grants/nhmrc/1117238 LIPPINCOTT WILLIAMS & WILKINS fulltext |
| spellingShingle | Science & Technology Life Sciences & Biomedicine Peripheral Vascular Disease Cardiovascular System & Cardiology ambulatory blood pressure blood pressure cardiovascular risk circadian rhythm women hypertension logistic equation men stroke DOUBLE-LOGISTIC ANALYSIS PROGNOSTIC-SIGNIFICANCE SURGE HYPERTENSION SILENT ASSOCIATION ACTIVATION PREDICTION MORTALITY INCREASE Adult Age Factors Aged Blood Pressure Blood Pressure Monitoring, Ambulatory Circadian Rhythm Female Humans Hypertension Male Middle Aged Risk Factors Sex Factors Stroke Humans Hypertension Blood Pressure Monitoring, Ambulatory Risk Factors Age Factors Sex Factors Circadian Rhythm Blood Pressure Adult Aged Middle Aged Female Male Stroke Head, G.A. Sata, Y. Imai, Y. Kikuya, M. Ohkubo, T. Reid, Christopher McGrath, B.M. Lukoshkova, E.V. Moderate morning rise in blood pressure has lowest risk of stroke but only in women |
| title | Moderate morning rise in blood pressure has lowest risk of stroke but only in women |
| title_full | Moderate morning rise in blood pressure has lowest risk of stroke but only in women |
| title_fullStr | Moderate morning rise in blood pressure has lowest risk of stroke but only in women |
| title_full_unstemmed | Moderate morning rise in blood pressure has lowest risk of stroke but only in women |
| title_short | Moderate morning rise in blood pressure has lowest risk of stroke but only in women |
| title_sort | moderate morning rise in blood pressure has lowest risk of stroke but only in women |
| topic | Science & Technology Life Sciences & Biomedicine Peripheral Vascular Disease Cardiovascular System & Cardiology ambulatory blood pressure blood pressure cardiovascular risk circadian rhythm women hypertension logistic equation men stroke DOUBLE-LOGISTIC ANALYSIS PROGNOSTIC-SIGNIFICANCE SURGE HYPERTENSION SILENT ASSOCIATION ACTIVATION PREDICTION MORTALITY INCREASE Adult Age Factors Aged Blood Pressure Blood Pressure Monitoring, Ambulatory Circadian Rhythm Female Humans Hypertension Male Middle Aged Risk Factors Sex Factors Stroke Humans Hypertension Blood Pressure Monitoring, Ambulatory Risk Factors Age Factors Sex Factors Circadian Rhythm Blood Pressure Adult Aged Middle Aged Female Male Stroke |
| url | http://purl.org/au-research/grants/nhmrc/317826 http://purl.org/au-research/grants/nhmrc/317826 http://purl.org/au-research/grants/nhmrc/317826 http://purl.org/au-research/grants/nhmrc/317826 http://purl.org/au-research/grants/nhmrc/317826 http://hdl.handle.net/20.500.11937/93778 |