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(Hypertension. 2006;47:139.)
© 2006 American Heart Association, Inc.

Editorial Commentaries

Caution for Winter Morning Surge in Blood Pressure

A Possible Link With Cardiovascular Risk in the Elderly

Kazuomi Kario

From the Division of Cardiology, Department of Medicine, Jichi Medical School, 3311-1, Yakushiji, Minamikawachi, Kawachi, Tochigi, 329-0498, Japan. E-mail: kkario@jichi.ac.jp

Correspondence to Kario Kazuomi, Division of Cardiology, Department of Medicine, Jichi Medical School, 3311-1, Yakushiji, Minamikawachi, Kawachi, Tochigi, 329-0498, Japan.

An extract of the first 250 words of the full text is provided, because this article has no abstract.

There are variations in the onset of cardiovascular events. As diurnal variation, most studies have shown an increased incidence of acute cardiovascular events such as acute myocardial infarction, sudden cardiac death, and stroke in the morning.¹ In addition, weekly and seasonal variations in the cardiovascular events have also been reported.² These variations may be closely associated with ambulatory blood pressure (BP) variations. In this issue, Modesti et al report an interesting study demonstrating weather-related change in ambulatory BP profile.³ In their study, in addition to poorly controlled nighttime BP in hot days, cold weather was significantly associated with increased morning BP surge in elderly subjects, even when they were treated with a higher number of antihypertensive drugs per day in cold weather. This cold weather-augmented morning BP surge may partly account for an increased number of cardiovascular events in the cold morning during the winter season.

Ambulatory BP also exhibits significant diurnal variation, and an abrupt BP surge in the morning has been suggested as a possible trigger for cardiovascular events. Previously, there were several areas of evidence indicating the importance of morning BP surge on cardiovascular disease. There are 2 relatively small prospective studies to support the possible risk of morning BP surge and cardiovascular events. The first is the Jichi Medical School (JMS) ambulatory blood pressure monitoring (ABPM) study (Wave 1) on elderly hypertensive patients⁴; the other is a French study on hypertensive patients.⁵ In the JMS ABPM, a prospective study of 519 elderly hypertensive patients with . . . [Full Text of this Article]

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Weather-Related Changes in 24-Hour Blood Pressure Profile: Effects of Age and Implications for Hypertension Management

Pietro Amedeo Modesti, Marco Morabito, Iacopo Bertolozzi, Luciano Massetti, Gabriele Panci, Camilla Lumachi, Alessia Giglio, Grzegorz Bilo, Gianluca Caldara, Laura Lonati, Simone Orlandini, Giampiero Maracchi, Giuseppe Mancia, Gian Franco Gensini, and Gianfranco Parati
Hypertension 2006 47: 155-161. [Abstract] [Full Text] [PDF]