Morning surge, dipping, and sleep-time blood pressure as prognostic markers of cardiovascular risk

The recently reported Monitorización Ambulatoria para Predicción de Eventos Cardiovasculares (MAPEC) study of 3344 subjects, with baseline BP ranging from normotension to sustained hypertension, and evaluated at least annually by 48-hour ABPM for a median duration of 5.6 years, found that a large MBPS was associated with a significantly lower CVD risk, in line with the lower risk associated with increased BP dipping. Furthermore, when the asleep BP mean was jointly incorporated with either the morning BP surge or awake BP mean in the same adjusted Cox regression model, only the asleep BP significantly predicted both total and major CVD events (CVD death, myocardial infarction, and stroke); findings were identical for the 607 MAPEC study patients with type 2 diabetes mellitus.