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dc.contributor.authorGuru P. Sogunuruen_US
dc.contributor.authorKazuomi Karioen_US
dc.contributor.authorJinho Shinen_US
dc.contributor.authorChen Huan Chenen_US
dc.contributor.authorPeera Buranakitjaroenen_US
dc.contributor.authorYook C. Chiaen_US
dc.contributor.authorRomeo Divinagraciaen_US
dc.contributor.authorJennifer Nailesen_US
dc.contributor.authorSungha Parken_US
dc.contributor.authorSaulat Siddiqueen_US
dc.contributor.authorJorge Sisonen_US
dc.contributor.authorArieska A. Soenartaen_US
dc.contributor.authorJam C. Tayen_US
dc.contributor.authorYuda Turanaen_US
dc.contributor.authorYuqing Zhangen_US
dc.contributor.authorSatoshi Hoshideen_US
dc.contributor.authorJi Guang Wangen_US
dc.contributor.otherDe La Salle Health Sciences Instituteen_US
dc.contributor.otherSunway Universityen_US
dc.contributor.otherHanyang University Medical Centeren_US
dc.contributor.otherJichi Medical Universityen_US
dc.contributor.otherShanghai Jiao Tong University School of Medicineen_US
dc.contributor.otherMadras Institute of Orthopaedics and Traumatology Hospitalsen_US
dc.contributor.otherKathmandu Universityen_US
dc.contributor.otherUniversity of the East Ramon Magsaysay Memorial Medical Centeren_US
dc.contributor.otherNational Yang-Ming University Taiwanen_US
dc.contributor.otherUniversitas Katolik Indonesia Atma Jayaen_US
dc.contributor.otherUniversitas Indonesiaen_US
dc.contributor.otherFuwai Hospitalen_US
dc.contributor.otherFaculty of Medicine, Siriraj Hospital, Mahidol Universityen_US
dc.contributor.otherTan Tock Seng Hospitalen_US
dc.contributor.otherPunjab Medical Centeren_US
dc.contributor.otherCardiovascular Hospitalen_US
dc.identifier.citationJournal of Clinical Hypertension. Vol.21, No.2 (2019), 324-334en_US
dc.description.abstract©2018 Wiley Periodicals, Inc. Hypertension is a major risk factor for cardiovascular and cerebrovascular diseases. To effectively prevent end-organ damage, maintain vascular integrity and reduce morbidity and mortality, it is essential to decrease and adequately control blood pressure (BP) throughout each 24-hour period. Exaggerated early morning BP surge (EMBS) is one component of BP variability (BPV), and has been associated with an increased risk of stroke and cardiovascular events, independently of 24-hour average BP. BPV includes circadian, short-term and long-term components, and can best be documented using out-of-office techniques such as ambulatory and/or home BP monitoring. There is a large body of evidence linking both BPV and EMBS with increased rates of adverse cardio- and cerebrovascular events, and end-organ damage. Differences in hypertension and related cardiovascular disease rates have been reported between Western and Asian populations, including a higher rate of stroke, higher prevalence of metabolic syndrome, greater salt sensitivity and more common high morning and nocturnal BP readings in Asians. This highlights a need for BP management strategies that take into account ethnic differences. In general, long-acting antihypertensives that control BP throughout the 24-hour period are preferred; amlodipine and telmisartan have been shown to control EMBS more effectively than valsartan. Home and ambulatory BP monitoring should form an essential part of hypertension management, with individualized pharmacotherapy to achieve optimal 24-hour BP control particularly the EMBS and provide the best cardio- and cerebrovascular protection. Future research should facilitate better understanding of BPV, allowing optimization of strategies for the detection and treatment of hypertension to reduce adverse outcomes.en_US
dc.rightsMahidol Universityen_US
dc.titleMorning surge in blood pressure and blood pressure variability in Asia: Evidence and statement from the HOPE Asia Networken_US
Appears in Collections:Scopus 2019

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