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    Moderate morning rise in blood pressure has lowest risk of stroke but only in women

    93583.pdf (1.331Mb)
    Access Status
    Open access
    Authors
    Head, G.A.
    Sata, Y.
    Imai, Y.
    Kikuya, M.
    Ohkubo, T.
    Reid, Christopher
    McGrath, B.M.
    Lukoshkova, E.V.
    Date
    2019
    Type
    Journal Article
    
    Metadata
    Show full item record
    Citation
    Head, G.A. and Sata, Y. and Imai, Y. and Kikuya, M. and Ohkubo, T. and Reid, C.M. and McGrath, B.M. et al. 2019. Moderate morning rise in blood pressure has lowest risk of stroke but only in women. Journal of Hypertension. 37 (7): pp. 1437-1447.
    Source Title
    Journal of Hypertension
    DOI
    10.1097/HJH.0000000000002027
    ISSN
    0263-6352
    Faculty
    Faculty of Health Sciences
    School
    Curtin School of Population Health
    Funding and Sponsorship
    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
    Remarks

    This is a non-final version of an article published in final form in Head, Geoffrey A.a; Sata, Yusukea; Imai, Yukatab; Kikuya, Masahiroc; Ohkubo, Takayoshic; Reid, Christopher M.d,e; McGrath, Barry M.f; Lukoshkova, Elena V.g. Moderate morning rise in blood pressure has lowest risk of stroke but only in women. Journal of Hypertension 37(7):p 1437-1447, July 2019. DOI: 10.1097/HJH.0000000000002027.

    URI
    http://hdl.handle.net/20.500.11937/93778
    Collection
    • Curtin Research Publications
    Abstract

    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.

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