gms | German Medical Science

29. Wissenschaftlicher Kongress der Deutschen Hochdruckliga

Deutsche Hochdruckliga e. V. DHL ® - Deutsche Hypertonie Gesellschaft Deutsches Kompetenzzentrum Bluthochdruck

23. bis 25.11.2005, Berlin

Is an increase of early morning surge in blood pressure associated with cardiotens detected ST segment depression?

Ist ein erhöhter early morning surge mit ST-Segmentsenkung vergesellschaftet?

Meeting Abstract

  • S. Uen - Universität Bonn (Bonn, D)
  • S. Asghari - Universität Bonn (Bonn, D)
  • J. Baulmann - Universität Bonn (Bonn, D)
  • H. Vetter - Universität Bonn (Bonn, D)
  • M. Mengden - Universität Bonn (Bonn, D)
  • I. Un - Kocaeli, Turkey

Hypertonie 2005. 29. Wissenschaftlicher Kongress der Deutschen Hochdruckliga. Berlin, 23.-25.11.2005. Düsseldorf, Köln: German Medical Science; 2006. Doc05hochP52

The electronic version of this article is the complete one and can be found online at:

Published: August 8, 2006

© 2006 Uen et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Background: Cardiovascular events occur most frequently in the early morning. It has been reported, that an exaggerated morning blood pressure surge (MBPS) was associated with silent hypertensive cerebrovascular disease. Therefore the aim of this study was to analyze, if there is a link between MBPS and ambulatory detected ST-segment depression.

Methods: Cardiotens records of 352 hypertensive patients were retrospectively collected and analyzed in a German multicenter study. Cardiotens device allows simultaneous 24-h ambulatory blood pressure measurement and ECG recording with additional blood pressure (BP) recording, triggered by ST segment analyse. ST segment depression was defined by the ``1-1-1 rule'': 1 mm horizontal or descending ST segment, 1 min duration and 1 min interval between two episodes. MBPS was calculated as the mean systolic BP during the 2 h after waking minus the mean systolic BP during 1 h that included the lowest sleep BP.

Results: The prevalence of ST segment depression did not differ between the Surge group (MBPS ³45 mm Hg, n = 37) and the Nonsurge group (MBPS < 45 mm Hg, n = 315) and amounted 22% and 22% respectively. 626 episodes of transient ST segment depression could be demonstrated in 47 patients. In 29 patients a depressed baseline ST segment of more than -0.10 mV was observed. The transient ST segment depression between 6 and 9 a.m. were characterized by a higher mean duration, a higher cumulative duration per hour and by a significant higher systolic blood pressure value (Table 1 [Tab. 1]).

Conclusion: ST-segment depression, detected with Cardiotens, has a circadian peak in the early morning hours like other cardiovascular events. Its duration is more severe, and systolic BP, as a possible trigger mechanism of such episodes, is higher in the early morning hours, than compared to other daytimes. An association between MBPS ³45 mm Hg with ST segment depression could not be demonstrated.