Association of an abnormal blood glucose level and morning blood pressure surge in elderly subjects with hypertension.

Abstract

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 > or =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 (CI) 1.26-2.72, P < 0.01) and higher fasting plasma glucose (10-mg/dl increase: OR 1.16, 95% CI 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.

• Authors: Motohiro Shimizu, Joji Ishikawa, Kazuo Eguchi, Satoshi Hoshide, Kazuyuki Shimada, Kazuomi Kario
• Journal: American journal of hypertension (Am J Hypertens) Vol. 22 Issue 6 Pg. 611-6 (Jun 2009) ISSN: 1941-7225 [Electronic] United States
• PMID: 19325533 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Blood Glucose

Topics

• Age Factors
• Aged
• Aged, 80 and over
• Blood Glucose (metabolism)
• Body Mass Index
• Circadian Rhythm (physiology)
• Confidence Intervals
• Fasting (physiology)
• Female
• Humans
• Hypertension (blood, complications, physiopathology)
• Japan (epidemiology)
• Male
• Middle Aged
• Odds Ratio
• Prognosis
• Stroke (epidemiology, etiology, physiopathology)