Supplemental Digital Content is available in the text. The cardiovascular disease (CVD) and mortality risk associated with morning blood pressure (BP) surge and its components among black adults, a population with high BP during the asleep period, is unknown. We studied Jackson Heart Study participants who completed 24-hour ambulatory BP monitoring at the baseline exam in 2000 to 2004 (n=761). The sleep-trough morning surge was calculated as the mean 2-hour postawakening systolic BP (SBP) minus the lowest nighttime SBP, preawakening morning surge as mean 2-hour postawakening SBP minus mean 2-hour preawakening SBP, and rising morning surge as the first postawakening SBP minus the last preawakening SBP. The primary outcome was the occurrence of CVD events including the composite of coronary heart disease or stroke. Over a median follow-up of 14.0 years, there were 74 CVD (coronary heart disease or stroke) events and 144 deaths. Higher tertiles of sleep-trough, preawakening, and rising SBP surge were not associated with CVD risk after multivariable adjustment. In contrast, the highest tertile of the individual components of morning surge, including postawakening SBP (tertiles 2 and 3 versus 1: hazard ratio [95% CI]: 1.58 [0.71–3.53] and 4.04 [1.91–8.52], respectively), lowest nighttime SBP (1.29 [0.59–2.84] and 2.87 [1.41–5.83]), preawakening SBP (1.26 [0.57–2.80] and 2.79 [1.32–5.93]), first postawakening SBP (1.60 [0.73–3.51] and 2.93 [1.40–6.16]), and last preawakening SBP (1.23 [0.57–2.68] and 2.99 [1.46–6.12]), was associated with increased CVD risk after multivariable adjustment. Among black adults, the components of morning SBP surge, but not morning SBP surge itself, were associated with increased CVD risk.

中文翻译：

---

黑人早晨血压飙升和心血管疾病事件以及全因死亡率

补充数字内容在文本中可用。与早晨血压 (BP) 激增及其成分相关的心血管疾病 (CVD) 和死亡风险在黑人成年人（睡眠期间血压高的人群）中是未知的。我们研究了 2000 年至 2004 年在基线检查时完成 24 小时动态血压监测的杰克逊心脏研究参与者（n=761）。睡眠谷晨峰计算为平均 2 小时觉醒后收缩压 (SBP) 减去最低夜间 SBP，唤醒前晨峰计算为平均 2 小时觉醒后 SBP 减去平均 2 小时觉醒前 SBP，上升的晨峰为第一次觉醒后 SBP 减去最后一次觉醒前 SBP。主要结果是 CVD 事件的发生，包括冠心病或中风的复合事件。超过 14 次的中位随访。0 年，有 74 起 CVD（冠心病或中风）事件和 144 人死亡。多变量调整后，较高的睡眠低谷、觉醒前和 SBP 升高的三分位数与 CVD 风险无关。相比之下，早晨激增的各个组成部分的最高三分位数，包括醒来后的 SBP（三分位数 2 和 3 对 1：风险比 [95% CI]：1.58 [0.71-3.53] 和 4.04 [1.91-8.52]，分别），夜间最低 SBP（1.29 [0.59-2.84] 和 2.87 [1.41-5.83]），觉醒前 SBP（1.26 [0.57-2.80] 和 2.79 [1.32-5.93]），觉醒后第一次 SBP（1.60 [1.41-5.83]） 1.40–6.16]）和最后一次觉醒前 SBP（1.23 [0.57–2.68] 和 2.99 [1.46–6.12]），在多变量调整后与 CVD 风险增加相关。在黑人成年人中，早晨 SBP 激增的组成部分，而不是早晨 SBP 激增本身，