Patients with a morning blood pressure rise of over 10 mmHg show a higher risk of left ventricular hypertrophy, even after adjusting for age, BMI, and other factors, according to a recent study.

The study involved 297 hypertensive Japanese patients (188 men, 109 women) treated with amlodipine monotherapy at an average dose of 5.5 mg/day over one year. Researchers assessed the association between morning blood pressure (BP) increases and left ventricular mass index (LVMI) using cardiac echocardiography and home BP monitoring. Patients were grouped based on morning and evening systolic blood pressure (SBP) readings. Findings indicated that patients with morning hypertension (morning SBP ≥135 mmHg) or a morning BP rise (ΔHSBP ≥10 mmHg) displayed elevated LVMI, even after adjustments for age, BMI, and alcohol intake.

The study, published in Hypertension Research, identified ΔHSBP as a dominant predictor of LVH, explaining 36.2% of the variability in LVMI. When combined with morning SBP, insulin resistance (HOMA-IR), and age, the regression model accounted for 44.1% of LVMI variance. Patients in the morning hypertension group had a significantly higher LVMI (123.0 g/m²) than those in the good control group (93.4 g/m², p<0.001). The morning hypertension group also showed increased insulin resistance (HOMA-IR: 2.87 vs. 1.58, p<0.001), suggesting a link between BP variability and metabolic factors.

These results suggest that tracking morning BP fluctuations in hypertensive patients may provide insight into cardiovascular risk. Monitoring both BP variability and metabolic factors, as highlighted by the study, could aid in assessing hypertensive target organ damage risk.

Full disclosures can be found in the published study.