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Kazuomi Kario - One of the best experts on this subject based on the ideXlab platform.
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associations between characteristics of obstructive sleep apnea and nocturnal blood Pressure Surge
Hypertension, 2018Co-Authors: Nobuo Sasaki, Satoshi Hoshide, Michiaki Nagai, Hiroyuki Mizuno, Mitsuo Kuwabara, Kazuomi KarioAbstract:Research suggests that oxygen desaturation and sleep stage during obstructive sleep apnea (OSA) are related to the magnitude of high blood Pressure (BP) in a laboratory setting. However, in a clini...
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comparative effects of valsartan plus either cilnidipine or hydrochlorothiazide on home morning blood Pressure Surge evaluated by information and communication technology based nocturnal home blood Pressure monitoring
Journal of Clinical Hypertension, 2018Co-Authors: Takeshi Fujiwara, Naoko Tomitani, Hiroshi Kanegae, Kazuomi KarioAbstract:The authors tested the hypothesis that a valsartan/cilnidipine combination would suppress the home morning blood Pressure (BP) Surge (HMBPS) more effectively than a valsartan/hydrochlorothiazide combination in patients with morning hypertension, defined as systolic BP (SBP) ≥135 mm Hg or diastolic BP ≥85 mm Hg assessed by a self-measuring information and communication technology-based home BP monitoring device more than three times before either combination's administration. This was an 8-week prospective, multicenter, randomized, open-label clinical trial. The HMBPS, which is a new index, was defined as the mean morning SBP minus the mean nocturnal SBP, both measured on the same day. The authors randomly allocated 129 patients to the valsartan/cilnidipine (63 patients; mean 68.4 years) or valsartan/hydrochlorothiazide (66 patients; mean 67.3 years) combination groups, and the baseline HMBPS values were 17.4 mm Hg vs 16.9 mm Hg, respectively (P = .820). At the end of the treatment period, the changes in nocturnal SBP and morning SBP from baseline were significant in both the valsartan/cilnidipine and valsartan/hydrochlorothiazide groups (P < .001): -5.0 vs -10.0 mm Hg (P = .035) and -10.7 vs -13.6 mm Hg (P = .142), respectively. HMBPS was significantly decreased from baseline in both groups (P < .001), but there was no significant difference between the two groups: 14.4 mm Hg vs 14.0 mm Hg, respectively (P = .892). Valsartan/cilnidipine could not significantly suppress HMBPS compared with valsartan/hydrochlorothiazide. Large-scale randomized controlled studies are needed to assess how reducing HMBPS will affect future cardiovascular outcomes. The information and communication technology-based home BP monitoring device may become an alternative to ambulatory BP monitoring, which has been a gold standard to measure nocturnal BP and the morning BP Surge.
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prognostic utility of morning blood Pressure Surge for 20 year all cause and cardiovascular mortalities results of a community based study
Journal of the American Heart Association, 2017Co-Authors: Haomin Cheng, Kazuomi Kario, Shih Hsien Sung, Jia Chun Lee, Chern En Chiang, Chi Jung Huang, Pai Feng Hsu, Shaoyuan ChuangAbstract:BackgroundMorning blood Pressure (BP) Surge (MS), defined by the MS amplitude, is an independent prognostic factor of cardiovascular outcomes in some, but not all, populations. Method and ResultsWe...
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morning blood Pressure Surge as a predictor of development of chronic kidney disease
Journal of Clinical Hypertension, 2016Co-Authors: Osman Turak, Kazuomi Kario, Baris Afsar, Firat Ozcan, Mehmet Ali Mendi, Fatih Oksuz, Dimitrie Siriopol, Kumral Cagli, Cagri Yayla, Adrian CovicAbstract:Blood Pressure (BP) usually increases upon awakening--a physiological mechanism called morning BP Surge (MBPS). BP values above the MBPS threshold are associated with target organ damage, including left ventricular hypertrophy and proteinuria. Despite these data, there have been no studies that have investigated the association between elevated MBPS and the development of incident chronic kidney disease (CKD). In this study, patients with essential hypertension were included and underwent ambulatory BP measurements and MBPS. Patients were followed for a median of 3.33 years. In total, 622 patients were enrolled. The mean age of patients was 57.6±12.4 years, 54.0% were men, 16.7% had diabetes, and 10.6% had prevalent cardiovascular disease. During follow-up, 32 patients developed CKD. Higher MBPS, analyzed both as continuous and categorical variables, was associated with incident CKD in all models. Elevated MBPS is associated with kidney function deterioration and the development of CKD. Studies are needed to further examine underlying mechanisms regarding MBPS and these renal outcomes.
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recurrence of stroke caused by nocturnal hypoxia induced blood Pressure Surge in a young adult male with severe obstructive sleep apnea syndrome
Journal of The American Society of Hypertension, 2016Co-Authors: Tetsuro Yoshida, Mitsuo Kuwabara, Satoshi Hoshide, Kazuomi KarioAbstract:Obstructive sleep apnea syndrome (OSAS) causes resistant hypertension and a hypopnea-related nocturnal blood Pressure (BP) Surge. This could lead to an increase of not only the nocturnal BP level but also nocturnal BP variability, both of which increase an individual's cardiovascular risk. We recently developed a trigger sleep BP monitoring method that initiates BP measurement when an individual's oxygen desaturation falls below a variable threshold, and we demonstrated that it can detect a BP Surge during apnea episodes. We here report the case of a 36-year-old man with severe OSAS who experienced the recurrence of stroke due to nocturnal hypoxia and a nocturnal BP Surge measured by this trigger sleep BP monitoring device. A nocturnal BP Surge during sleep in OSAS patients could be a strong trigger of cardiovascular events.
Satoshi Hoshide - One of the best experts on this subject based on the ideXlab platform.
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associations between characteristics of obstructive sleep apnea and nocturnal blood Pressure Surge
Hypertension, 2018Co-Authors: Nobuo Sasaki, Satoshi Hoshide, Michiaki Nagai, Hiroyuki Mizuno, Mitsuo Kuwabara, Kazuomi KarioAbstract:Research suggests that oxygen desaturation and sleep stage during obstructive sleep apnea (OSA) are related to the magnitude of high blood Pressure (BP) in a laboratory setting. However, in a clini...
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recurrence of stroke caused by nocturnal hypoxia induced blood Pressure Surge in a young adult male with severe obstructive sleep apnea syndrome
Journal of The American Society of Hypertension, 2016Co-Authors: Tetsuro Yoshida, Mitsuo Kuwabara, Satoshi Hoshide, Kazuomi KarioAbstract:Obstructive sleep apnea syndrome (OSAS) causes resistant hypertension and a hypopnea-related nocturnal blood Pressure (BP) Surge. This could lead to an increase of not only the nocturnal BP level but also nocturnal BP variability, both of which increase an individual's cardiovascular risk. We recently developed a trigger sleep BP monitoring method that initiates BP measurement when an individual's oxygen desaturation falls below a variable threshold, and we demonstrated that it can detect a BP Surge during apnea episodes. We here report the case of a 36-year-old man with severe OSAS who experienced the recurrence of stroke due to nocturnal hypoxia and a nocturnal BP Surge measured by this trigger sleep BP monitoring device. A nocturnal BP Surge during sleep in OSAS patients could be a strong trigger of cardiovascular events.
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ethnic differences in the degree of morning blood Pressure Surge and in its determinants between japanese and european hypertensive subjectsnovelty and significance
Hypertension, 2015Co-Authors: Satoshi Hoshide, Kazuomi Kario, Grzegorz Bilo, Alejandro De La Sierra, Giuseppe Schillaci, Jose R Banegas, Manuel Gorostidi, Julian Segura, Carolina Lombardi, Stefano OmboniAbstract:Morning blood Pressure (BP) Surge has been reported to be a prognostic factor for cardiovascular events. Its determinants are still poorly defined, however. In particular, it is not clear whether ethnic differences play a role in determining morning Surge (MS) size. Aim of our study was to explore whether differences exist in the size of MS between Japanese and Western European hypertensive patients. We included 2887 untreated hypertensive patients (age 62.3±8.8 years) from a European ambulatory BP monitoring database and 811 hypertensive patients from a Japanese database (Jichi Medical School Ambulatory Blood Pressure Monitoring WAVE1, age 72.3±9.8 years) following the same inclusion criteria. Their 24-hour ambulatory BP monitoring recordings were analyzed focusing on MS. Sleep-trough MS was defined as the difference between mean systolic BP during the 2 hours after awakening and mean systolic BP during the 1-hour night period that included the lowest sleep BP level. The sleep-trough MS was higher in Japanese than in European hypertensive patients after adjusting for age and 24-hour mean BP levels (40.1 [95% confidence interval 39.0–41.2] versus 23.0 [22.4–23.5] mm Hg; P <0.001). This difference remained significant after accounting for differences in night-time BP dipping. Age was independently associated with MS in the Japanese database, but not in the European subjects. Our results for the first time show the occurrence of substantial ethnic differences in the degree of MS. These findings may help in understanding the role of ethnic factors in cardiovascular risk assessment and in identifying possible ethnicity-related differences in the most effective measures to be implemented for prevention of BP-related cardiovascular events. # Novelty and Significance {#article-title-46}
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ethnic differences in the degree of morning blood Pressure Surge and in its determinants between japanese and european hypertensive subjectsnovelty and significance data from the artemis study
Hypertension, 2015Co-Authors: Satoshi Hoshide, Kazuomi Kario, Grzegorz Bilo, Alejandro De La Sierra, Giuseppe Schillaci, Jose R Banegas, Manuel Gorostidi, Julian Segura, Carolina Lombardi, Stefano OmboniAbstract:Morning blood Pressure (BP) Surge has been reported to be a prognostic factor for cardiovascular events. Its determinants are still poorly defined, however. In particular, it is not clear whether ethnic differences play a role in determining morning Surge (MS) size. Aim of our study was to explore whether differences exist in the size of MS between Japanese and Western European hypertensive patients. We included 2887 untreated hypertensive patients (age 62.3±8.8 years) from a European ambulatory BP monitoring database and 811 hypertensive patients from a Japanese database (Jichi Medical School Ambulatory Blood Pressure Monitoring WAVE1, age 72.3±9.8 years) following the same inclusion criteria. Their 24-hour ambulatory BP monitoring recordings were analyzed focusing on MS. Sleep-trough MS was defined as the difference between mean systolic BP during the 2 hours after awakening and mean systolic BP during the 1-hour night period that included the lowest sleep BP level. The sleep-trough MS was higher in Japanese than in European hypertensive patients after adjusting for age and 24-hour mean BP levels (40.1 [95% confidence interval 39.0–41.2] versus 23.0 [22.4–23.5] mm Hg; P
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ethnic differences in the degree of morning blood Pressure Surge and in its determinants between japanese and european hypertensive subjects data from the artemis study
Hypertension, 2015Co-Authors: Satoshi Hoshide, Kazuomi Kario, Grzegorz Bilo, Alejandro De La Sierra, Giuseppe Schillaci, Jose R Banegas, Manuel Gorostidi, Julian Segura, Carolina Lombardi, Stefano OmboniAbstract:Morning blood Pressure (BP) Surge has been reported to be a prognostic factor for cardiovascular events. Its determinants are still poorly defined, however. In particular, it is not clear whether ethnic differences play a role in determining morning Surge (MS) size. Aim of our study was to explore whether differences exist in the size of MS between Japanese and Western European hypertensive patients. We included 2887 untreated hypertensive patients (age 62.3±8.8 years) from a European ambulatory BP monitoring database and 811 hypertensive patients from a Japanese database (Jichi Medical School Ambulatory Blood Pressure Monitoring WAVE1, age 72.3±9.8 years) following the same inclusion criteria. Their 24-hour ambulatory BP monitoring recordings were analyzed focusing on MS. Sleep-trough MS was defined as the difference between mean systolic BP during the 2 hours after awakening and mean systolic BP during the 1-hour night period that included the lowest sleep BP level. The sleep-trough MS was higher in Japanese than in European hypertensive patients after adjusting for age and 24-hour mean BP levels (40.1 [95% confidence interval 39.0-41.2] versus 23.0 [22.4-23.5] mm Hg; P<0.001). This difference remained significant after accounting for differences in night-time BP dipping. Age was independently associated with MS in the Japanese database, but not in the European subjects. Our results for the first time show the occurrence of substantial ethnic differences in the degree of MS. These findings may help in understanding the role of ethnic factors in cardiovascular risk assessment and in identifying possible ethnicity-related differences in the most effective measures to be implemented for prevention of BP-related cardiovascular events.
Kazuyuki Shimada - One of the best experts on this subject based on the ideXlab platform.
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morning blood Pressure Surge morning platelet aggregation and silent cerebral infarction in older japanese hypertensive patients
Journal of Hypertension, 2011Co-Authors: Kazuomi Kario, Satoshi Hoshide, Yuichiro Yano, Takefumi Matsuo, Yujiro Asada, Kazuyuki ShimadaAbstract:OBJECTIVE To examine whether or not the extent of morning blood Pressure Surge (MBPS), defined as a morning SBP increase from sleep SBP, is associated with that of platelet aggregation, coagulation/fibrinolytic activity, and silent cerebral infarction (SCI) in older hypertensive patients. METHODS Sixty hypertensive patients aged at least 60 years (mean age 70.6 years; 40% men) underwent measurement of morning spontaneous small-sized platelet aggregation (SPA) detected by a light scattering intensity method, measurement of circulatory levels of von-Willebrand factor (vWF), noradrenalin, and plasma renin activity (PRA), and brain MRI. RESULTS The extent of MBPS, but not 24-h SBP, was associated with circulatory levels of noradrenalin, PRA, vWF, and spontaneous SPA (all P < 0.05); the association between MBPS and spontaneous SPA remained significant even after adjustment for significant covariates (P < 0.001). The patients with multiple (more than three per person) SCIs had a significantly greater extent of MBPS (43.3 vs. 31.8 mmHg), morning spontaneous SPA (20 471.9 vs. 4850.9 × 10(5) × 2 mV counts 10 min), and higher circulatory vWF (196.6 vs. 150.1%) compared with those without it (all P < 0.01). On multiple regression analysis, the odds ratio for multiple SCIs with a +1 SD increase of MBPS was 2.0, that of morning spontaneous SPA was 3.0, and that of circulatory morning vWF level was 3.3 (all P < 0.05). When MBPS increase and either platelet aggregation or vWF increases were entered into the same model, the latter parameters, but not the MBPS, were associated with multiple SCIs (both P < 0.05). CONCLUSION The extent of MBPS was associated with increased activity of morning platelet aggregation in older hypertensive patients.
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the relationship between the morning blood Pressure Surge and low grade inflammation on silent cerebral infarct and clinical stroke events
Atherosclerosis, 2011Co-Authors: Motohiro Shimizu, Joji Ishikawa, Yuichirou Yano, Satoshi Hoshide, Kazuyuki Shimada, Kazuomi KarioAbstract:Abstract Objective Morning blood Pressure Surge (MBPS) has been shown to be a risk factor for cardiovascular disease and is associated with vascular remodeling. This study investigated whether the cerebrovascular risk of MBPS is modified by low-grade inflammation. Methods We evaluated ambulatory BP, high sensitivity C-reactive protein (hsCRP), and brain MRI at baseline in 514 Japanese hypertensive patients, and followed them for the incidence of stroke for an average of 41 months (range: 1–68 months, 1751 person-years). Results MBPS was significantly correlated with the hsCRP level in patients with the highest quartile of MBPS, but not in the other quartiles. The odds ratio for silent cerebral infarcts (SCIs) was significantly higher only in patients in the highest quartile of MBPS with higher (above median) hsCRP [odds ratio 2.74, 95% confidence interval (CI) 1.42–5.30] in comparison with those in other quartiles of MBPS and with lower (below median) hsCRP. Conversely, being in the highest quartile of MBPS and having a higher hsCRP were independently and additively associated with an increased risk for clinical stroke events (both the highest quartile of MBPS and the higher hsCRP; hazard ratio [HR] 5.77, 95%CI 2.11–15.81, only the highest quartile of MBPS; HR 3.03, 95%CI 0.89–10.33, only the higher hsCRP; HR 2.89, 95%CI 1.12–7.47), even after adjusting for confounding factors. Conclusion Exaggerated MBPS and increased low-grade inflammation independently increase the risk of stroke, while the relationship between exaggerated MBPS and the presence of SCIs is slightly affected by low-grade inflammation.
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additional impact of morning haemostatic risk factors and morning blood Pressure Surge on stroke risk in older japanese hypertensive patients
European Heart Journal, 2011Co-Authors: Kazuomi Kario, Yuichirou Yano, Satoshi Hoshide, Kazuo Eguchi, Takefumi Matsuo, Kazuyuki ShimadaAbstract:Aims Stroke events occur most frequently in the morning hours. Impaired haemostatic activity and morning blood Pressure (BP) Surge, defined as the morning BP increase from sleep, have individually been associated with stroke risk in general or hypertensive populations. However, their combined impact on the risk of a stroke remains unknown. Methods and results A total of 514 hypertensive patients aged >50 years (mean 72.3 years; 37%men) underwent 24 h BP monitoring, measurement of haemostatic risk factors [plasma fibrinogen, plasminogen activator inhibitor-1 (PAI-1), and prothrombin fragment 1+2(F1+2)], and brain MRI at baseline. The incidence of stroke was prospectively ascertained. During an average of 41 months (1751 person-years), there were 43 stroke events (ischaemic, 30; haemorrhagic, 5; undefined, 8). On multivariable analysis adjusted for confounding factors, the hazard ratio [HR (95% confidence interval (CI)] for stroke in the highest vs. lower quartiles of PAI-1 was 2.5 (1.3–4.6), that for F1+2 was 2.6 (1.4–5.0), and that for the morning BP Surge was 1.2 (1.1–1.4; all P < 0.01). In particular, the ratio was substantially higher in cases with the highest quartile of both PAI-1 and F1+2 levels compared with those with the lower quartiles of both parameters (HR: 8.2; 95% CI: 3.7–18.2; P < 0.001). Among the patients with the highest quartile of the morning BP Surge ( n = 128), the multivariable HR (95% CI) for the highest vs. lower quartiles of PAI-1 was 3.4 (1.3–9.1) and that for F1+2 was 3.3 (1.3–8.7) (both P < 0.05). Conclusion High levels of plasma PAI-1 and F1+2, as well as an excessive morning BP Surge, are independently and additively associated with an increased risk of stroke in older hypertensive patients.
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association between morning blood Pressure Surge and cardiovascular remodeling in treated elderly hypertensive subjects
American Journal of Hypertension, 2009Co-Authors: Yuichiro Yano, Satoshi Hoshide, Kazuyuki Shimada, Takashi Inokuchi, Yoshimasa Kanemaru, Kazuomi KarioAbstract:BACKGROUND It has remained unclear whether or not morning blood Pressure (BP) Surge (MS) is associated with cardiovascular remodeling in elderly (≥60 years) hypertensive patients being treated by antihypertensive medications. METHODS In this cross-sectional study (n = 197; mean 74.6 years; 37% men), we evaluated the association between MS, defined as the highest quartile of morning BP increase from sleep (≥48 mm Hg; n = 49), and extent of cardiac hypertrophy and carotid artery intima-media thickness (IMT). RESULTS Although there were no differences in 24-h BP levels and the number of prescribed antihypertensive medications between MS and non-MS group, the use of thiazide diuretics was more frequent in MS group than non-MS group (35% vs. 19%; P < 0.05).The MS group had significantly higher levels of left ventricular mass index (LVMI) and internal-carotid artery (ICA)-IMT than the non-MS group (both P < 0.01), independent of 24-h BP levels, daytime BP variability, the degree of nocturnal BP decline, the plasma low-density lipoprotein levels, and the use of diuretics. Even in subjects with a well-controlled 24-h BP level (<130/80 mm Hg; n = 75), these relationships were similar. A multiple logistic regression analysis showed that the presence of MS was an independent determinant of LV hypertrophy (LVH) (≥125 g/m 2 in men and ≥110 g/m 2 in women) and assignment to the highest quartile of ICA-IMT (both P < 0.05). CONCLUSIONS The MS in subjects being treated with antihypertensive medications was significantly associated with cardiovascular remodeling, independently of 24-h BP level, daytime BP variability, and nocturnal BP decline.
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association of an abnormal blood glucose level and morning blood Pressure Surge in elderly subjects with hypertension
American Journal of Hypertension, 2009Co-Authors: Motohiro Shimizu, Joji Ishikawa, Satoshi Hoshide, Kazuyuki Shimada, Kazuo Eguchi, Kazuomi KarioAbstract:BACKGROUND: We previously reported that morning blood Pressure (BP) Surge (MBPS) was an independent risk factor for stroke. We evaluated the determinants of MBPS in hypertensive patients. METHODS: We analyzed 24-h ambulatory BP monitoring (ABPM) records in 458 hypertensive patients (mean: 72.2 +/- 8.5 years). The MBPS was calculated as the mean systolic BP (SBP) over 2 h after waking minus mean SBP during the hour of sleep that included the lowest nighttime BP. The cutoff value for identifying the top decile (the MBPS group) was defined as > or =55 mm Hg. RESULTS: The MBPS was associated with age, fasting plasma glucose, and 24-h SBP, and they were independent and significant determinants of MBPS in multivariate analysis (age, P = 0.01; fasting plasma glucose, P < 0.01; 24-h SBP, P = 0.04) after adjustment for confounding factors of gender, body mass index (BMI), and smoking status. The subjects in the MBPS group (n = 45) were older in age (76.4 years vs. 71.8 years, P < 0.01) and had higher fasting plasma glucose (97.6 mg/dl vs. 91.4 mg/dl, P = 0.04) than those in the non-MBPS group. In logistic regression analysis, the MBPS group was associated with older age (10 years older: odds ratio (OR) 1.85, 95% confidence interval (CI) 1.26-2.72, P < 0.01) and higher fasting plasma glucose (10-mg/dl increase: OR 1.16, 95% CI 1.01-1.33, P = 0.03). CONCLUSION: In addition to older age and higher mean 24-h SBP, higher fasting plasma glucose was associated with MBPS.
Yuichiro Yano - One of the best experts on this subject based on the ideXlab platform.
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nocturnal blood Pressure morning blood Pressure Surge and cerebrovascular events
Current Hypertension Reports, 2012Co-Authors: Yuichiro Yano, Kazuomi KarioAbstract:Cerebrovascular disease is a common cause of death and major cause of disability worldwide. Even in silent cases (e.g., silent cerebral infarction, white matter lesion), cerebrovascular disease can lead to physical and cognitive impairment, thereby substantially reducing the activities of daily living. Accordingly, the earliest possible action to prevent not only symptomatic but also silent cerebrovascular disease has become a major public health challenge. Hypertension is a potent risk factor for both symptomatic and silent cerebrovascular disease. Twenty-four–hour blood Pressure (BP) rather than office BP is closely associated with cerebrovascular disease and/or poor physical and cognitive function. In particular, nocturnal BP and morning BP Surge have attracted much attention as risk factors for cerebrovascular diseases independently of 24-h BP level. This review is an attempt to summarize some of the evidence on nocturnal BP level or nocturnal BP dipping status, and morning BP Surge as potent risk factors for cerebrovascular disease.
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morning blood Pressure Surge morning platelet aggregation and silent cerebral infarction in older japanese hypertensive patients
Journal of Hypertension, 2011Co-Authors: Kazuomi Kario, Satoshi Hoshide, Yuichiro Yano, Takefumi Matsuo, Yujiro Asada, Kazuyuki ShimadaAbstract:OBJECTIVE To examine whether or not the extent of morning blood Pressure Surge (MBPS), defined as a morning SBP increase from sleep SBP, is associated with that of platelet aggregation, coagulation/fibrinolytic activity, and silent cerebral infarction (SCI) in older hypertensive patients. METHODS Sixty hypertensive patients aged at least 60 years (mean age 70.6 years; 40% men) underwent measurement of morning spontaneous small-sized platelet aggregation (SPA) detected by a light scattering intensity method, measurement of circulatory levels of von-Willebrand factor (vWF), noradrenalin, and plasma renin activity (PRA), and brain MRI. RESULTS The extent of MBPS, but not 24-h SBP, was associated with circulatory levels of noradrenalin, PRA, vWF, and spontaneous SPA (all P < 0.05); the association between MBPS and spontaneous SPA remained significant even after adjustment for significant covariates (P < 0.001). The patients with multiple (more than three per person) SCIs had a significantly greater extent of MBPS (43.3 vs. 31.8 mmHg), morning spontaneous SPA (20 471.9 vs. 4850.9 × 10(5) × 2 mV counts 10 min), and higher circulatory vWF (196.6 vs. 150.1%) compared with those without it (all P < 0.01). On multiple regression analysis, the odds ratio for multiple SCIs with a +1 SD increase of MBPS was 2.0, that of morning spontaneous SPA was 3.0, and that of circulatory morning vWF level was 3.3 (all P < 0.05). When MBPS increase and either platelet aggregation or vWF increases were entered into the same model, the latter parameters, but not the MBPS, were associated with multiple SCIs (both P < 0.05). CONCLUSION The extent of MBPS was associated with increased activity of morning platelet aggregation in older hypertensive patients.
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association between morning blood Pressure Surge and cardiovascular remodeling in treated elderly hypertensive subjects
American Journal of Hypertension, 2009Co-Authors: Yuichiro Yano, Satoshi Hoshide, Kazuyuki Shimada, Takashi Inokuchi, Yoshimasa Kanemaru, Kazuomi KarioAbstract:BACKGROUND It has remained unclear whether or not morning blood Pressure (BP) Surge (MS) is associated with cardiovascular remodeling in elderly (≥60 years) hypertensive patients being treated by antihypertensive medications. METHODS In this cross-sectional study (n = 197; mean 74.6 years; 37% men), we evaluated the association between MS, defined as the highest quartile of morning BP increase from sleep (≥48 mm Hg; n = 49), and extent of cardiac hypertrophy and carotid artery intima-media thickness (IMT). RESULTS Although there were no differences in 24-h BP levels and the number of prescribed antihypertensive medications between MS and non-MS group, the use of thiazide diuretics was more frequent in MS group than non-MS group (35% vs. 19%; P < 0.05).The MS group had significantly higher levels of left ventricular mass index (LVMI) and internal-carotid artery (ICA)-IMT than the non-MS group (both P < 0.01), independent of 24-h BP levels, daytime BP variability, the degree of nocturnal BP decline, the plasma low-density lipoprotein levels, and the use of diuretics. Even in subjects with a well-controlled 24-h BP level (<130/80 mm Hg; n = 75), these relationships were similar. A multiple logistic regression analysis showed that the presence of MS was an independent determinant of LV hypertrophy (LVH) (≥125 g/m 2 in men and ≥110 g/m 2 in women) and assignment to the highest quartile of ICA-IMT (both P < 0.05). CONCLUSIONS The MS in subjects being treated with antihypertensive medications was significantly associated with cardiovascular remodeling, independently of 24-h BP level, daytime BP variability, and nocturnal BP decline.
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unresolved issues of the morning blood Pressure Surge the next stage of clinical applicability for the morning Surge
Hypertension Research, 2008Co-Authors: Yuichiro Yano, Kazuomi KarioAbstract:Unresolved Issues of the Morning Blood Pressure Surge: The Next Stage of Clinical Applicability for the Morning Surge
Stefano Omboni - One of the best experts on this subject based on the ideXlab platform.
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ethnic differences in the degree of morning blood Pressure Surge and in its determinants between japanese and european hypertensive subjectsnovelty and significance
Hypertension, 2015Co-Authors: Satoshi Hoshide, Kazuomi Kario, Grzegorz Bilo, Alejandro De La Sierra, Giuseppe Schillaci, Jose R Banegas, Manuel Gorostidi, Julian Segura, Carolina Lombardi, Stefano OmboniAbstract:Morning blood Pressure (BP) Surge has been reported to be a prognostic factor for cardiovascular events. Its determinants are still poorly defined, however. In particular, it is not clear whether ethnic differences play a role in determining morning Surge (MS) size. Aim of our study was to explore whether differences exist in the size of MS between Japanese and Western European hypertensive patients. We included 2887 untreated hypertensive patients (age 62.3±8.8 years) from a European ambulatory BP monitoring database and 811 hypertensive patients from a Japanese database (Jichi Medical School Ambulatory Blood Pressure Monitoring WAVE1, age 72.3±9.8 years) following the same inclusion criteria. Their 24-hour ambulatory BP monitoring recordings were analyzed focusing on MS. Sleep-trough MS was defined as the difference between mean systolic BP during the 2 hours after awakening and mean systolic BP during the 1-hour night period that included the lowest sleep BP level. The sleep-trough MS was higher in Japanese than in European hypertensive patients after adjusting for age and 24-hour mean BP levels (40.1 [95% confidence interval 39.0–41.2] versus 23.0 [22.4–23.5] mm Hg; P <0.001). This difference remained significant after accounting for differences in night-time BP dipping. Age was independently associated with MS in the Japanese database, but not in the European subjects. Our results for the first time show the occurrence of substantial ethnic differences in the degree of MS. These findings may help in understanding the role of ethnic factors in cardiovascular risk assessment and in identifying possible ethnicity-related differences in the most effective measures to be implemented for prevention of BP-related cardiovascular events. # Novelty and Significance {#article-title-46}
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ethnic differences in the degree of morning blood Pressure Surge and in its determinants between japanese and european hypertensive subjectsnovelty and significance data from the artemis study
Hypertension, 2015Co-Authors: Satoshi Hoshide, Kazuomi Kario, Grzegorz Bilo, Alejandro De La Sierra, Giuseppe Schillaci, Jose R Banegas, Manuel Gorostidi, Julian Segura, Carolina Lombardi, Stefano OmboniAbstract:Morning blood Pressure (BP) Surge has been reported to be a prognostic factor for cardiovascular events. Its determinants are still poorly defined, however. In particular, it is not clear whether ethnic differences play a role in determining morning Surge (MS) size. Aim of our study was to explore whether differences exist in the size of MS between Japanese and Western European hypertensive patients. We included 2887 untreated hypertensive patients (age 62.3±8.8 years) from a European ambulatory BP monitoring database and 811 hypertensive patients from a Japanese database (Jichi Medical School Ambulatory Blood Pressure Monitoring WAVE1, age 72.3±9.8 years) following the same inclusion criteria. Their 24-hour ambulatory BP monitoring recordings were analyzed focusing on MS. Sleep-trough MS was defined as the difference between mean systolic BP during the 2 hours after awakening and mean systolic BP during the 1-hour night period that included the lowest sleep BP level. The sleep-trough MS was higher in Japanese than in European hypertensive patients after adjusting for age and 24-hour mean BP levels (40.1 [95% confidence interval 39.0–41.2] versus 23.0 [22.4–23.5] mm Hg; P
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ethnic differences in the degree of morning blood Pressure Surge and in its determinants between japanese and european hypertensive subjects data from the artemis study
Hypertension, 2015Co-Authors: Satoshi Hoshide, Kazuomi Kario, Grzegorz Bilo, Alejandro De La Sierra, Giuseppe Schillaci, Jose R Banegas, Manuel Gorostidi, Julian Segura, Carolina Lombardi, Stefano OmboniAbstract:Morning blood Pressure (BP) Surge has been reported to be a prognostic factor for cardiovascular events. Its determinants are still poorly defined, however. In particular, it is not clear whether ethnic differences play a role in determining morning Surge (MS) size. Aim of our study was to explore whether differences exist in the size of MS between Japanese and Western European hypertensive patients. We included 2887 untreated hypertensive patients (age 62.3±8.8 years) from a European ambulatory BP monitoring database and 811 hypertensive patients from a Japanese database (Jichi Medical School Ambulatory Blood Pressure Monitoring WAVE1, age 72.3±9.8 years) following the same inclusion criteria. Their 24-hour ambulatory BP monitoring recordings were analyzed focusing on MS. Sleep-trough MS was defined as the difference between mean systolic BP during the 2 hours after awakening and mean systolic BP during the 1-hour night period that included the lowest sleep BP level. The sleep-trough MS was higher in Japanese than in European hypertensive patients after adjusting for age and 24-hour mean BP levels (40.1 [95% confidence interval 39.0-41.2] versus 23.0 [22.4-23.5] mm Hg; P<0.001). This difference remained significant after accounting for differences in night-time BP dipping. Age was independently associated with MS in the Japanese database, but not in the European subjects. Our results for the first time show the occurrence of substantial ethnic differences in the degree of MS. These findings may help in understanding the role of ethnic factors in cardiovascular risk assessment and in identifying possible ethnicity-related differences in the most effective measures to be implemented for prevention of BP-related cardiovascular events.