Morning surge of blood pressure - clinical relevance, review of definitions

Abstract

The morning rise of blood pressure, especially after morning physical activity, is a physiological reaction. On the other hand excessive and rapid morning peak of BP (morning surge) is a risk factor for organ damage and probably causes high prevalence of cardiovascular incidents in the morning. This paper discusses pathomechanism, clinician aspects and type of defining of blood pressure morning surge.
So far definitions of morning surge of blood pressure differ from one another. Some of them defined morning surge of blood pressure as the difference between blood pressure after waking up and one hour before. Others, define the morning rise of BP according to the lowest BP value during nighttime. Most of the authors recognize excessive morning peak of blood pressure as BP values which reflect 90th percentile of the morning-night difference. Important clinical aspect of the morning surge is prevention of cardiovascular incidents by effective, pharmacological 24 hour control of blood pressure.