Association of an Abnormal Blood Glucose Level and Morning Blood Pressure Surge in Elderly Subjects With Hypertension

作者：Shimizu Motohiro; Ishikawa Joji; Eguchi Kazuo; Hoshide Satoshi; Shimada Kazuyuki; Kario Kazuomi^*

来源：American Journal of Hypertension, 2009, 22(6): 611-616.

DOI：10.1038/ajh.2009.61

BACKGROUND We previously reported that morning blood pressure (BP) surge (MBPS) was an independent risk factor for stroke. We evaluated the determinants of MBPS in hypertensive patients.
METHODS
We analyzed 24-h ambulatory BP monitoring (ABPM) records in 458 hypertensive patients (mean: 72.2 +/- 8.5 years). The MBPS was calculated as the mean systolic BP (SBP) over 2 h after waking minus mean SBP during the hour of sleep that included the lowest nighttime BP. The cutoff value for identifying the top decile (the MBPS group) was defined as >= 55 mm Hg.
RESULTS
The MBPS was associated with age, fasting plasma glucose, and 24-h SBP, and they were independent and significant determinants of MBPS in multivariate analysis (age, P = 0.01; fasting plasma glucose, P < 0.01; 24-h SBP, P = 0.04) after adjustment for confounding factors of gender, body mass index (BMI), and smoking status. The subjects in the MBPS group (n = 45) were older in age (76.4 years vs. 71.8 years, P < 0.01) and had higher fasting plasma glucose (97.6 mg/dl vs. 91.4 mg/dl, P = 0.04) than those in the non-MBPS group. In logistic regression analysis, the MBPS group was associated with older age (10 years older: odds ratio (OR) 1.85, 95% confidence interval (0) 1.26-2.72, P < 0.01) and higher fasting plasma glucose (10-mg/dl increase: OR 1.16, 95% Cl 1.01-1.33, P = 0.03).
CONCLUSION
In addition to older age and higher mean 24-h SBP, higher fasting plasma glucose was associated with MBPS.

• 出版日期2009-6