CARDIAC IMPLICATIONS OF THE MORNING SURGE IN BLOOD-PRESSURE IN ELDERLY HYPERTENSIVE PATIENTS - RELATION TO ARISING TIME

Although morning surge in blood pressure has been shown to be associat ed with the occurrence of myocardial ischemic events and stroke, few s tudies have been done regarding its pathogenesis, probably because of a lack of method for the quantitative assessment of awakening time. We conducted an echocardiographic study and ambulatory blood pressure mo nitoring in 23 elderly hypertensive patients to evaluate the relations hip between the hypertensive cardiac change and morning surge in blood pressure. Of note was that the time of arising from bed was assessed quantitatively by an activetracer equipped with an internal accelerati on sensor to monitor the physical activity. The change in systolic blo od pressure after arising from bed was correlated significantly with t he left ventricular mass index (r = 0.51, P < .02) and the A/E ratio, which represents the diastolic function (r = 0.70, P < .01). In contra st, the change in systolic blood pressure before rising from bed was n ot correlated with any echocardiographic parameters. We conclude that the magnitude of morning surge in blood pressure after arising from be d was related with the severity of hypertensive target organ damage.