Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.
Medical Research Council: Research Unit for Hypertension and Cardiovascular Disease, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.
J Hum Hypertens. 2019 Jan;33(1):22-33. doi: 10.1038/s41371-018-0089-3. Epub 2018 Jul 23.
An exaggerated morning blood pressure surge (MBPS) has independent predictive value for cardiovascular mortality and is suggested to be prevalent in elderly hypertensive patients: men and white populations. To better understand the MBPS profile in a young and normotensive population, we evaluated the MBPS in young adults and explored associations with demographic, cardiovascular and health behaviour measurements. We included 845 black (n = 439) and white (n = 406) men and women aged between 20 and 30 years. We calculated the sleep-trough and dynamic morning surge, and compared demographic data, health behaviours and ambulatory blood pressure according to MBPS quartiles. In the total group, higher waist circumference, socioeconomic score, lean mass, ambulatory blood pressure (24-h, daytime blood pressure) and increased night-time dipping (all p < 0.05) were found in the highest sleep-trough and dynamic morning surge quartiles. In the total white group, particularly men, both sleep-trough and dynamic morning surge were higher than the black group (all p < 0.013). More black participants were non-dippers than whites (44% vs 34%; p = 0.004). In multivariable adjusted regression in the total group, we found no consistent associations of MBPS with demographic and health behaviour measurements. MBPS related independently and positively with night-time percentage dipping in all ethnic groups (all p < 0.01). Ethnic differences in MBPS is evident in young adults, with a higher, but normal MBPS in white men. A non-dipping night-time pattern in young black adults (with reduced MBPS) and a higher MBPS (observed in dippers) may serve as potential risk factors for cardiovascular disease.
清晨血压飙升幅度（MBPS）过高具有独立的心血管死亡率预测价值，并且在老年高血压患者中更为常见：男性和白种人群。为了更好地了解年轻且血压正常人群的 MBPS 特征，我们评估了年轻成年人的 MBPS，并探讨了其与人口统计学、心血管和健康行为测量的相关性。我们纳入了 845 名年龄在 20 至 30 岁之间的黑种人（n=439）和白种人（n=406）男女。我们计算了睡眠-突破和动态清晨激增，并根据 MBPS 四分位数比较了人口统计学数据、健康行为和动态血压。在总人群中，最高睡眠-突破和动态清晨激增四分位数组的腰围、社会经济评分、瘦体重、动态血压（24 小时、日间血压）更高，夜间降压幅度更大（均 P<0.05）。在白种人总人群中，尤其是男性，睡眠-突破和动态清晨激增均高于黑种人（均 P<0.013）。与白人相比，黑人中更多的是非杓型血压（44%比 34%；P=0.004）。在总人群的多变量调整回归中，我们发现 MBPS 与人口统计学和健康行为测量之间没有一致的相关性。MBPS 与所有种族群体的夜间降压幅度百分比呈独立且正相关（均 P<0.01）。在年轻成年人中，MBPS 存在明显的种族差异，白种男性的 MBPS 较高，但处于正常范围内。年轻黑人的夜间非杓型血压模式（MBPS 降低）和杓型血压（MBPS 升高）可能是心血管疾病的潜在危险因素。
