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The clinical significance of early morning hypertension(EMHT) is not still somewhat clear. We evaluated the prevalence of masked early morning or nocturnal hypertension (NHT) and effects of arterial stiffness, pulse wave velocity(PWV) and wave reflections on central aortic pressure (CAP) in hypertensive patients with ischemic stroke(IS).
We analyzed a total 450 hypertensive patients with IS, investigate masked hypertension(MHT) using 24hr ambulatory blood pressure monitoring (ABPM). Among the MHT, classified as masked EMHT (early morning BP ≥ 135/85 mmHg and night-time BP ≤ 120/70 mmHg), Masked NHT(Daytime BP ≤ 135/85 mmHg and night-time BP ≥120/70 mmHg). And using radial artery applanation tonometry, aortic pulse analysis was performed in MHT.
128 patients was observed MHT with ischemic stroke. EMHT was found in 55.6% of MHT patients (n=71). Compared with patients with both EMHT and NHT, EMHT had higher aortic pulse wave velocity(PWV) and augmentation index(AI) and AI75 (AI to HR 75 beat/min), ASP (Central aortic systolic pressure) and pulse pressure were also higher in the EMHT.
Our results suggest that higher prevalence of masked EMHT. A significant increase of early morning BP, especial systolic BP, might be predictive risk factor of ischemic stroke events rather than nocturnal BP. Hence ASP measurements might be particularly important for the early detection of ischemic stroke event.