Early morning is usually the time of day when human blood pressure is highest, and 60% of sudden deaths, heart attacks and strokes in clinical practice occur during this time. Therefore, for many hypertensive patients, a good control of blood pressure in the early morning means a good control of blood pressure throughout the day. Early morning blood pressure 1. Definition: Normal blood pressure has a circadian rhythm of “double peak – valley”, that is, the blood pressure is lower at night and fluctuates at a higher level during the day. Whether a person with normal blood pressure or hypertension, blood pressure rises rapidly in the morning after awakening and returning to an upright position. After a person goes from sleep to wakefulness and begins to move, blood pressure rises rapidly from a lower level, which is the stage with a greater degree of circadian blood pressure variability. In hypertensive patients, the average systolic blood pressure rises by 14 mmHg between 6:00 and 10:00 a.m., and may even rise by 80 mmHg. This rapid rise in blood pressure in the early morning is called the morning peak of blood pressure at home and abroad. The Chinese Guidelines for the Prevention and Treatment of Hypertension 2010 emphasize the importance of blood pressure variability and morning blood pressuresurge (MBPS) in the prevention and treatment of hypertension, and point out that morning blood pressure is established by ambulatory blood pressure monitoring. Prospective and cross-sectional studies have shown that increased morning peak blood pressure is an independent risk factor for cardiovascular disease. Even in hypertensive patients with well-controlled blood pressure, increased MBPS is independently associated with the risk of cardiovascular disease and is independent of 24-h mean blood pressure. 2. Causes and hazards: 3. Importance: Clinical studies have now 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 associated with increased blood pressure in the early morning hours, independently of 24-h mean 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. Controlling blood pressure in the early morning is an important part of preventing myocardial infarction and stroke attacks. For the vast majority of patients, early morning blood pressure is the windward MATCH marker for controlling blood pressure throughout the day and 24 hours. By monitoring blood pressure in the early morning before taking medication, it is a good way to determine whether the patient’s antihypertensive treatment plan can truly control blood pressure for 24 hours. 4.Cautions for assessing early morning blood pressure: (1) Do it within half an hour to one hour after waking up; (usually between 6:00~10:00) (2) Empty urine and stool; (3) Skip breakfast; (4) Measure blood pressure before taking medication; (5) Sit down and rest for 5 minutes-10 minutes before starting blood pressure measurement. 5.What to do? The 2013 European hypertension guidelines again point out that the current measures to prevent and treat hypertension are mainly lifestyle changes and medication. The former advocates continuing to lie in bed or getting up slowly on your side after waking up in the morning, not exercising strenuously after getting up, avoiding emotional excitement, etc. At the same time, salt intake should be strictly controlled, quitting smoking and alcohol, exercising, maintaining psychological balance, eating more fruits and vegetables, etc. Medication includes the following aspects: 1. Choose long-acting and stable antihypertensive drugs to keep blood pressure stable for 24 h. 2. Patients with high blood pressure in the early morning can take medication at bedtime under the guidance of the doctor to control morning peak blood pressure, but cannot adjust the time of taking medication by themselves. If the blood pressure is not well controlled, 24-hour ambulatory blood pressure should be done and the doctor will adjust the dosing time accordingly.