After a person goes from sleep to wakefulness and starts activity, blood pressure rises rapidly from a lower level and is the phase with a greater degree of diurnal blood pressure variability. In patients with untreated hypertension, the average systolic blood pressure rises 14 mmHg between 6:00 and 10:00 a.m.
mmHg, or even 80 mmHg, and this rapid rise in blood pressure early in the morning is called the morning peak of blood pressure at home and abroad. Currently, clinical studies have confirmed that cardiovascular events such as sudden cardiac death, myocardial infarction, unstable angina and hemorrhagic and ischemic stroke are particularly likely to occur in the early morning and are closely related to the early morning blood pressure increase, independently of the 24h average blood pressure. Compared to other times of the day, the risk of heart attack is 40% higher, the risk of sudden cardiac death is 29% higher, and the risk of all types of stroke is 49% higher in the early morning hours. Therefore, effective control of the morning peak of blood pressure can help reduce the occurrence of triggering cardiovascular events. The treatment of morning sickness is now considered to be to change the time of administration to bedtime and to use drugs with a long duration of action. The best way to control the morning peak is to use a strong, long-lasting and stable antihypertensive drug. The external causes of hypertension early in the morning “morning peak” phenomenon include standing and the start of daytime activities; while the internal causes may be related to the rapid increase in platelet aggregation rate, increased plasma cortisol, increased blood viscosity, relative fibrinolysis deficiency and other factors. So, how can we stop the “morning peak” of cardiovascular disease? In the choice of antihypertensive drugs, the current medical consensus is to give preference to long-acting antihypertensive drugs that are administered once a day and have a continuous 24-hour antihypertensive effect. However, it often takes 2 to 3 hours for these antihypertensive drugs to take effect, so it is ideal to choose drugs with fast and long-lasting antihypertensive effects. In order to suppress the morning peak and the use of evening or bedtime antihypertensive drugs, we should be careful not to make the night blood pressure too low, it can cause cerebral blood supply and posterior ciliary artery hypoperfusion, resulting in optic nerve papillary infarction (papilledema) and so on.