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Morning hypertension in chronic kidney disease is sustained type, but not surge type.

Abstract：

OBJECTIVE:We have shown that as renal function deteriorates, the circadian blood pressure (BP) rhythm shifts to a nondipper pattern and the duration until nocturnal BP decline [dipping time (DT)] is prolonged. We investigated whether or not morning hypertension (BP 2 h after awakening >135/85 mmHg) in chronic kidney disease (CKD) was sustained type with a prolonged DT. MATERIALS AND METHODS:Twenty-four-hour BP was monitored in 104 patients with CKD. Fifty-one of 104 participants (group A) did not exhibit morning hypertension. The patients with morning hypertension (group B, n=53) were classified into three groups: group C (n=23), participants who exhibited morning hypertension but did not meet the criteria for the surge or sustained type; group D (n=29), the sustained type (with no night-time BP readings <120/70 mmHg); and group E (n=1), the surge type (systolic BP rises >25 mmHg after awakening). RESULTS:The night/day BP ratio and DT were compared among groups A, C, and D because there was only one participant in group E. Night/day ratio of BP and DT were both significantly higher in group D compared with groups A and C. The prevalence of nondippers tended to be higher in group D compared with the other groups (A, 65%; C, 57%; D, 86%, P=0.09). Creatinine clearance was significantly lower in group D compared with groups A and C. CONCLUSION:Sustained elevation of night-time BP until the early morning and high night/day ratio of BP may contribute to the high frequency of morning hypertension, which is generally the sustained rather than the surge type in CKD.

journal_name

Blood Press Monit

journal_title

Blood pressure monitoring

authors

Mizuno M,Fukuda M,Miura T,Wakamatsu T,Naito T,Sato R,Togawa H,Sasakawa Y,Tomonari T,Ono M,Kato Y,Ichikawa T,Shirasawa Y,Ito A,Yoshida A,Kimura G

doi

10.1097/MBP.0b013e32835026c6

subject

Has Abstract

pub_date

2012-02-01 00:00:00

pages

20-3

issue

1

eissn

1359-5237

issn

1473-5725

journal_volume

17

pub_type

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