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.

doi:10.1097/HJH.0000000000002027

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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.