Morning blood pressure surge relates to autonomic neural activity in young non-dipping adults: The African-PREDICT study
| dc.contributor.author | Mokwatsi, G.G | |
| dc.contributor.author | Schutte, A.E | |
| dc.contributor.author | Mels, C.M.C | |
| dc.contributor.author | Kruger, R | |
| dc.date.accessioned | 2024-10-02T11:03:48Z | |
| dc.date.available | 2024-10-02T11:03:48Z | |
| dc.date.issued | 2019-08 | |
| dc.description.abstract | Background: It is well established that an exaggerated morning blood pressure surge (MBPS) is associated with an increased risk for cardiovascular disease development in hypertensive individuals. However, in non-dipping individuals, a lower surge was reportedly associated with increased cardiovascular risk. Sympathetic nervous system activity is involved in 24-hour blood pressure fluctuations, including night-time dipping and the MBPS. To better understand this interaction, we investigated associations of MBPS with heart-rate variability and baroreceptor sensitivity in young healthy dippers and non-dippers. Methods: We included black and white men and women (n=827), aged 20-30 years and determined the MBPS using two formulas: the sleep-trough and dynamic morning surge. For autonomic function we determined baroreceptor sensitivity and heart-rate variability. Results: The majority of non-dippers in this population were black (70.4%), presenting lower sleep-trough and dynamic morning surge (all p<0.001). Heart-rate variability was comparable between dippers and non-dippers, whereas baroreceptor sensitivity was higher in non-dippers (p=0.021). Despite a suppressed MBPS profile in non-dippers, we found both sleep-trough (β=-0.25; p=0.039) and dynamic morning surge (β=-0.14; p=0.047) to be inversely and independently associated with 24-hour heart-rate variability (total power). These results were absent in dippers. Conclusions: In conclusion, we found a higher night-time blood pressure coupled with lower MBPS in young healthy non-dippers. Furthermore, this lower MBPS was independently and negatively associated with autonomic neural activity, suggesting increased autonomic function involvement in MBPS suppression of non-dippers. The predictive value of suppressed nocturnal dipping pattern should be investigated while taking autonomic neural activity into account. | |
| dc.description.sponsorship | The African-PREDICT study is an ongoing study financially supported by the South African Medical Research Council (SAMRC) with funds from National Treasury under its Economic Competitiveness and Support Package; the South African Research Chairs Initiative (SARChI) of the Department of Science and Technology and National Research Foundation (NRF) of South Africa; the Strategic Health Innovation Partnerships (SHIP) Unit of the SAMRC with funds received from the South African National Department of Health, GlaxoSmithKline R&D, the UK Medical Research Council and with funds from the UK Government’s Newton Fund. | |
| dc.identifier.citation | Mokwatsi GG, Schutte AE, Mels CMC, Kruger R. Morning Blood Pressure Surge Relates to Autonomic Neural Activity in Young Non-Dipping Adults: The African-PREDICT Study. Heart Lung Circ. 2019 Aug;28(8):1197-1205. doi: 10.1016/j.hlc.2018.07.003. | |
| dc.identifier.uri | https://pubmed.ncbi.nlm.nih.gov/30093314/ | |
| dc.identifier.uri | https://doi.org/10.1016/j.hlc.2018.07.003 | |
| dc.identifier.uri | https://hdl.handle.net/11288/597682 | |
| dc.language.iso | en | |
| dc.publisher | Elsevier | |
| dc.subject | Autonomic neural activity | |
| dc.subject | Dippers | |
| dc.subject | Morning blood pressure surge | |
| dc.subject | Non-dippers | |
| dc.title | Morning blood pressure surge relates to autonomic neural activity in young non-dipping adults: The African-PREDICT study | |
| dc.type | Article |