Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
Department of Cardiovascular Medicine, the Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, State Key Laboratory of Medical Genomics, National Research Centre for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
J Clin Hypertens (Greenwich). 2022 Sep;24(9):1112-1120. doi: 10.1111/jch.14555.
Morning hypertension is an important clinical target in the management of hypertension for perfect 24-h blood pressure (BP) control. Morning hypertension is generally categorized into two types: "morning surge" type and "sustained nocturnal and morning hypertension" type. The "morning surge" type is characterized by an exaggerated morning blood pressure surge (MBPS), and the "sustained nocturnal and morning hypertension" type with continuous hypertension from nighttime to morning (non-dipper/riser type). They can be detected by home and ambulatory blood pressure measurements (HBPM and ABPM). These two forms of morning hypertension both increase the risk of cardiovascular and renal diseases, but may occur via different pathogenic mechanisms and are associated with different conditions. Morning hypertension should be treated to achieve a morning BP level of < 135/85 mmHg, regardless of the office BP. The second target morning BP levels is < 125/75 mmHg for high-risk patients with morning hypertension and concomitant diseases. Morning hypertension is more frequently found in Asians, than in Westerners. Thus, the management of morning hypertension is especially important in Asia. The detection of morning hypertension and the individual home BP-guided treatment approach targeting morning BP in combination with ABPM, and the optimal treatment of morning hypertension would reduce cardiovascular events in Asia.
晨峰高血压是高血压管理中控制 24 小时血压的重要临床目标。晨峰高血压通常分为两种类型：“晨峰”型和“夜间和晨峰持续高血压”型。“晨峰”型的特点是晨峰血压（MBPS）明显升高，“夜间和晨峰持续高血压”型则表现为夜间到清晨持续高血压（非杓型/杓型升高）。它们可以通过家庭和动态血压测量（HBPM 和 ABPM）来检测。这两种形式的晨峰高血压都会增加心血管和肾脏疾病的风险，但可能通过不同的发病机制发生，并且与不同的情况有关。无论诊室血压如何，都应治疗晨峰高血压，使晨峰血压水平<135/85mmHg。对于有晨峰高血压和合并症的高危患者，第二个目标晨峰血压水平为<125/75mmHg。晨峰高血压在亚洲人群中比在西方人中更为常见。因此，亚洲地区的晨峰高血压管理尤为重要。检测晨峰高血压，并结合 ABPM 对晨峰血压进行个体化家庭血压指导治疗，以及优化晨峰高血压的治疗，可以减少亚洲地区的心血管事件。
