Additional impact of morning haemostatic risk factors and morning blood pressure surge on stroke risk in older Japanese hypertensive patients.

摘要: Aims Stroke events occur most frequently in the morning hours. Impaired haemostatic activity and blood pressure (BP) surge, defined as BP increase from sleep, have individually been associated with stroke risk general or hypertensive populations. However, their combined impact on of a remains unknown. Methods results A total 514 patients aged >50 years (mean 72.3 years; 37%men) underwent 24 h monitoring, measurement factors [plasma fibrinogen, plasminogen activator inhibitor-1 (PAI-1), prothrombin fragment 1+2(F1+2)], brain MRI at baseline. The incidence was prospectively ascertained. During an average 41 months (1751 person-years), there were 43 (ischaemic, 30; haemorrhagic, 5; undefined, 8). On multivariable analysis adjusted for confounding factors, hazard ratio [HR (95% confidence interval (CI)] highest vs. lower quartiles PAI-1 2.5 (1.3–4.6), that F1+2 2.6 (1.4–5.0), surge 1.2 (1.1–1.4; all P < 0.01). In particular, substantially higher cases quartile both levels compared those parameters (HR: 8.2; 95% CI: 3.7–18.2; 0.001). Among ( n = 128), HR CI) 3.4 (1.3–9.1) 3.3 (1.3–8.7) (both 0.05). Conclusion High plasma F1+2, well excessive are independently additively increased older patients.