REVIEWSMorning blood pressure monitoring in the management of hypertensionWang, Ji-Guanga; Kario, Kazuomib; Park, Jeong-Baec; Chen, Chen-Huand,e,fAuthor Information aDepartment of Hypertension, Centre for Epidemiological Studies and Clinical Trials, Shanghai Key Laboratory of Hypertension, The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China bDivision of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan cCardiovascular Division, Cheil General Hospital, Kwandong University College of Medicine, Seoul, South Korea dDepartment of Medical Education, Taipei Veterans General Hospital eDepartment of Medicine fDepartment of Public Health, Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan Correspondence to Ji-Guang Wang, MD, PhD, Department of Hypertension, Centre for Epidemiological Studies and Clinical Trials, Shanghai Key Laboratory of Hypertension, The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Ruijin 2nd Road 197, Shanghai 200025, China. Tel: +86 21 64370045x610911; fax: +86 21 64662193; e-mail: [email protected] Abbreviations: CI, confidence interval; CV, cardiovascular; HCTZ, hydrochlorothiazide; HF, heart failure; HR, hazard ratio; MI, myocardial infarction; TIA, transient ischaemic attack Received 24 June, 2016 Revised 12 March, 2017 Accepted 22 March, 2017 Journal of Hypertension: August 2017 - Volume 35 - Issue 8 - p 1554-1563 doi: 10.1097/HJH.0000000000001379 Buy Metrics Abstract The aim of the current article is to review the current evidence on the role of morning blood pressure (BP) in the management of hypertension. Morning BP surge had been and will continue to be a hot topic of hypertension research. However, more evidence is needed to prove its clinical usefulness in the management of hypertension. Masked morning hypertension, as the other forms of masked hypertension, requires more research. The concept of morning BP monitoring could be clinically relevant in the therapeutic management of hypertension and in the prevention of cardiovascular complications by defining and treating morning hypertension. Antihypertensive medication is usually taken in the morning. The presence of uncontrolled morning BP during trough effect hours could be a hallmark of inadequate antihypertensive regimen, such as, for instance, the use of short-acting or intermediate-acting drugs, under dosing of drugs, or no or low use of combination therapy. To improve the management of hypertension in general and morning hypertension in particular, long-acting antihypertensive drugs should be used in appropriate often full dosages and in proper combinations. The clinical usefulness of antihypertensive drugs of specific mechanisms against morning BP or split or timed dosing of long-acting drugs in controlling morning BP remains under investigation. In conclusion, there is some evidence that morning BP is critical in the incidence of cardiovascular complications. However, proving its clinical usefulness in the management of hypertension requires further research. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.