Researchers advise people with high blood pressure – who typically monitor their blood pressure at home – to measure the blood pressure in the morning rather than in the evening, because it may estimate the risk of stroke a lot better.
In the study, researchers at Jichi Medical University in Japan analysed data on Japanese people and found that higher blood pressure measured in the morning was linked to an increased risk of stroke. When measured in the evening, higher blood pressure was not tied to stroke risk as much as in the aforementioned case.
Dr. Satoshi Hoshide, lead author of the study and an associate professor of cardiovascular medicine at Jichi Medical University, said that high blood pressure is more common in people who live in Asia than in Western populations. Blood pressure also has the tendency to be higher in the morning, Dr. Hoshide added.
On November 8 at the American Heart Association Scientific Sessions meeting, Hoshide advised people to measure their blood pressure in the morning, especially those in Asian populations.
More than 4,300 people in Japan who suffered from high blood pressure, diabetes, or heart cholesterol took park in the study. The researchers asked the participants to measure their blood pressure at home, once in the morning and once in the evening over the course of two weeks. In the follow-up period, the participants were tracked for another four years. About 75 strokes occurred during the follow-up.
The findings showed that when measured in the morning, blood pressure higher than 155 mm Hg was linked to a seven times higher stroke risk than in the case of a 135 mm Hg morning blood pressure. In the case of evening blood pressure, the researchers found no difference in the risk of stroke between a 155 mm Hg blood pressure and one that was 135 mm Hg.
According to Dr. Hoshide, evening blood pressure may be influence by outside factors like warm showers or hot baths, which is why it is less predictive of people’s stroke risk.
Morning blood pressure surge is tied to physiological factors such as the sympathetic nervous system (SNS) that activates when you wake up in the morning (although technically it is constantly active at a basic level to sustain homeostasis). The primary process of the sympathetic nervous system is to stimulate the fight-and-flight response of the body.
Because the current study was conducted in a Japanese population, it is not clear whether the same results would occur in other populations, Dr. Hoshide said.
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