Arq. Bras. Cardiol. 2023; 120(9): e20230608

Morning Surge Blood Pressure and Obesity in Hypertensive Patients

Sayuri Inuzuka , Weimar Kunz Sebba Barroso

DOI: 10.36660/abc.20230608

This Short Editorial is referred by the Research article "Association between Morning Surge and Left Ventricular Hypertrophy in Obese Hypertensive Patients".

Obesity and hypertension are two of the most common diseases and they are usually interrelated. The five main modifiable risk factors – dyslipidemia, diabetes, hypertension, obesity and smoking are estimated to account for more than 50% of cardiovascular mortality. There are many hypertensive patients with subclinical lesions in the early stages of the disease that are not generally identified by the traditional assessment model.^, The presence of left ventricular hypertrophy (LVH) determines general risk stratification and is a major therapeutic target in hypertension. Both obesity and hypertension may have additive and interactive effects on LVH. In order to identify early cardiovascular system damage, more specific complementary exams for biomarker analysis have been recommended by hypertension guidelines.^–

Different methods to determine morning surge blood pressure (MSBP) elevation have been proposed,^– but there are still several gaps regarding the establishment of cutoffs and clinical meaningful recommendations. Some studies showed that MSBP have an adverse prognostic value, independently of 24h mean blood pressure. However, due to the difficulty in standardizing the calculation of this parameter, the incremental predictive value is still unclear and its low reproducibility indicate that, according to guidelines, it should not be used in clinical practice.^,

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