Morning surge in blood pressure and blood pressure variability in Asia: Evidence and statement from the HOPE Asia Network

HOPE Asia Network

Research output: Contribution to journalReview article

13 Citations (Scopus)

Abstract

Hypertension is a major risk factor for cardiovascular and cerebrovascular diseases. To effectively prevent end-organ damage, maintain vascular integrity and reduce morbidity and mortality, it is essential to decrease and adequately control blood pressure (BP) throughout each 24-hour period. Exaggerated early morning BP surge (EMBS) is one component of BP variability (BPV), and has been associated with an increased risk of stroke and cardiovascular events, independently of 24-hour average BP. BPV includes circadian, short-term and long-term components, and can best be documented using out-of-office techniques such as ambulatory and/or home BP monitoring. There is a large body of evidence linking both BPV and EMBS with increased rates of adverse cardio- and cerebrovascular events, and end-organ damage. Differences in hypertension and related cardiovascular disease rates have been reported between Western and Asian populations, including a higher rate of stroke, higher prevalence of metabolic syndrome, greater salt sensitivity and more common high morning and nocturnal BP readings in Asians. This highlights a need for BP management strategies that take into account ethnic differences. In general, long-acting antihypertensives that control BP throughout the 24-hour period are preferred; amlodipine and telmisartan have been shown to control EMBS more effectively than valsartan. Home and ambulatory BP monitoring should form an essential part of hypertension management, with individualized pharmacotherapy to achieve optimal 24-hour BP control particularly the EMBS and provide the best cardio- and cerebrovascular protection. Future research should facilitate better understanding of BPV, allowing optimization of strategies for the detection and treatment of hypertension to reduce adverse outcomes.

Original languageEnglish
Pages (from-to)324-334
Number of pages11
JournalJournal of Clinical Hypertension
Volume21
Issue number2
DOIs
Publication statusPublished - 2019 Feb 1

Fingerprint

Blood Pressure
Ambulatory Blood Pressure Monitoring
Valsartan
Hypertension
Cardiovascular Diseases
Cerebrovascular Disorders
Antihypertensive Agents
Blood Vessels
Reading
Salts
Stroke
Myocardial Infarction
Morbidity
Drug Therapy
Mortality
Population

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Cardiology and Cardiovascular Medicine

Cite this

@article{1b8277c7d3b545bbb8d137057d91c0a8,
title = "Morning surge in blood pressure and blood pressure variability in Asia: Evidence and statement from the HOPE Asia Network",
abstract = "Hypertension is a major risk factor for cardiovascular and cerebrovascular diseases. To effectively prevent end-organ damage, maintain vascular integrity and reduce morbidity and mortality, it is essential to decrease and adequately control blood pressure (BP) throughout each 24-hour period. Exaggerated early morning BP surge (EMBS) is one component of BP variability (BPV), and has been associated with an increased risk of stroke and cardiovascular events, independently of 24-hour average BP. BPV includes circadian, short-term and long-term components, and can best be documented using out-of-office techniques such as ambulatory and/or home BP monitoring. There is a large body of evidence linking both BPV and EMBS with increased rates of adverse cardio- and cerebrovascular events, and end-organ damage. Differences in hypertension and related cardiovascular disease rates have been reported between Western and Asian populations, including a higher rate of stroke, higher prevalence of metabolic syndrome, greater salt sensitivity and more common high morning and nocturnal BP readings in Asians. This highlights a need for BP management strategies that take into account ethnic differences. In general, long-acting antihypertensives that control BP throughout the 24-hour period are preferred; amlodipine and telmisartan have been shown to control EMBS more effectively than valsartan. Home and ambulatory BP monitoring should form an essential part of hypertension management, with individualized pharmacotherapy to achieve optimal 24-hour BP control particularly the EMBS and provide the best cardio- and cerebrovascular protection. Future research should facilitate better understanding of BPV, allowing optimization of strategies for the detection and treatment of hypertension to reduce adverse outcomes.",
author = "{HOPE Asia Network} and Sogunuru, {Guru P.} and Kazuomi Kario and Jinho Shin and Chen, {Chen Huan} and Peera Buranakitjaroen and Chia, {Yook C.} and Romeo Divinagracia and Jennifer Nailes and Sungha Park and Saulat Siddique and Jorge Sison and Soenarta, {Arieska A.} and Tay, {Jam C.} and Yuda Turana and Yuqing Zhang and Satoshi Hoshide and Wang, {Ji Guang}",
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language = "English",
volume = "21",
pages = "324--334",
journal = "Journal of Clinical Hypertension",
issn = "1524-6175",
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Morning surge in blood pressure and blood pressure variability in Asia : Evidence and statement from the HOPE Asia Network. / HOPE Asia Network.

In: Journal of Clinical Hypertension, Vol. 21, No. 2, 01.02.2019, p. 324-334.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Morning surge in blood pressure and blood pressure variability in Asia

T2 - Evidence and statement from the HOPE Asia Network

AU - HOPE Asia Network

AU - Sogunuru, Guru P.

AU - Kario, Kazuomi

AU - Shin, Jinho

AU - Chen, Chen Huan

AU - Buranakitjaroen, Peera

AU - Chia, Yook C.

AU - Divinagracia, Romeo

AU - Nailes, Jennifer

AU - Park, Sungha

AU - Siddique, Saulat

AU - Sison, Jorge

AU - Soenarta, Arieska A.

AU - Tay, Jam C.

AU - Turana, Yuda

AU - Zhang, Yuqing

AU - Hoshide, Satoshi

AU - Wang, Ji Guang

PY - 2019/2/1

Y1 - 2019/2/1

N2 - Hypertension is a major risk factor for cardiovascular and cerebrovascular diseases. To effectively prevent end-organ damage, maintain vascular integrity and reduce morbidity and mortality, it is essential to decrease and adequately control blood pressure (BP) throughout each 24-hour period. Exaggerated early morning BP surge (EMBS) is one component of BP variability (BPV), and has been associated with an increased risk of stroke and cardiovascular events, independently of 24-hour average BP. BPV includes circadian, short-term and long-term components, and can best be documented using out-of-office techniques such as ambulatory and/or home BP monitoring. There is a large body of evidence linking both BPV and EMBS with increased rates of adverse cardio- and cerebrovascular events, and end-organ damage. Differences in hypertension and related cardiovascular disease rates have been reported between Western and Asian populations, including a higher rate of stroke, higher prevalence of metabolic syndrome, greater salt sensitivity and more common high morning and nocturnal BP readings in Asians. This highlights a need for BP management strategies that take into account ethnic differences. In general, long-acting antihypertensives that control BP throughout the 24-hour period are preferred; amlodipine and telmisartan have been shown to control EMBS more effectively than valsartan. Home and ambulatory BP monitoring should form an essential part of hypertension management, with individualized pharmacotherapy to achieve optimal 24-hour BP control particularly the EMBS and provide the best cardio- and cerebrovascular protection. Future research should facilitate better understanding of BPV, allowing optimization of strategies for the detection and treatment of hypertension to reduce adverse outcomes.

AB - Hypertension is a major risk factor for cardiovascular and cerebrovascular diseases. To effectively prevent end-organ damage, maintain vascular integrity and reduce morbidity and mortality, it is essential to decrease and adequately control blood pressure (BP) throughout each 24-hour period. Exaggerated early morning BP surge (EMBS) is one component of BP variability (BPV), and has been associated with an increased risk of stroke and cardiovascular events, independently of 24-hour average BP. BPV includes circadian, short-term and long-term components, and can best be documented using out-of-office techniques such as ambulatory and/or home BP monitoring. There is a large body of evidence linking both BPV and EMBS with increased rates of adverse cardio- and cerebrovascular events, and end-organ damage. Differences in hypertension and related cardiovascular disease rates have been reported between Western and Asian populations, including a higher rate of stroke, higher prevalence of metabolic syndrome, greater salt sensitivity and more common high morning and nocturnal BP readings in Asians. This highlights a need for BP management strategies that take into account ethnic differences. In general, long-acting antihypertensives that control BP throughout the 24-hour period are preferred; amlodipine and telmisartan have been shown to control EMBS more effectively than valsartan. Home and ambulatory BP monitoring should form an essential part of hypertension management, with individualized pharmacotherapy to achieve optimal 24-hour BP control particularly the EMBS and provide the best cardio- and cerebrovascular protection. Future research should facilitate better understanding of BPV, allowing optimization of strategies for the detection and treatment of hypertension to reduce adverse outcomes.

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U2 - 10.1111/jch.13451

DO - 10.1111/jch.13451

M3 - Review article

C2 - 30525279

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JO - Journal of Clinical Hypertension

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