Mokwatsi, Gontse G.Schutte, Aletta E.Mels, Catharina M.C.Kruger, Ruan2018-08-222018-08-222019Mokwatsi, G.G. et al. 2019. Morning blood pressure surge relates to autonomic neural activity in young non-dipping adults: the African-PREDICT study. Heart, lung and circulation, 28(8):1197-1205. [https://doi.org/10.1016/j.hlc.2018.07.003]1443-95061444-2892 (Online)http://hdl.handle.net/10394/30780https://www.sciencedirect.com/science/article/pii/S1443950618318298https://doi.org/10.1016/j.hlc.2018.07.003Background It is well established that an exaggerated morning blood pressure surge (MBPS) is associated with an increased risk for cardiovascular disease development in hypertensive individuals. However, in non-dipping individuals, a lower surge was reportedly associated with increased cardiovascular risk. Sympathetic nervous system activity is involved in 24-hour blood pressure fluctuations, including night-time dipping and the MBPS. To better understand this interaction, we investigated associations of MBPS with heart-rate variability and baroreceptor sensitivity in young healthy dippers and non-dippers. Methods We included black and white men and women (n = 827), aged 20-30 years and determined the MBPS using two formulas: the sleep-trough and dynamic morning surge. For autonomic function we determined baroreceptor sensitivity and heart-rate variability. Results The majority of non-dippers in this population were black (70.4%), presenting lower sleep-trough and dynamic morning surge (all p < 0.001). Heart-rate variability was comparable between dippers and non-dippers, whereas baroreceptor sensitivity was higher in non-dippers (p = 0.021). Despite a suppressed MBPS profile in non-dippers, we found both sleep-trough (β = −0.25; p = 0.039) and dynamic morning surge (β = −0.14; p = 0.047) to be inversely and independently associated with 24-hour heart-rate variability (total power). These results were absent in dippers. Conclusions In conclusion, we found a higher night-time blood pressure coupled with lower MBPS in young healthy non-dippers. Furthermore, this lower MBPS was independently and negatively associated with autonomic neural activity, suggesting increased autonomic function involvement in MBPS suppression of non-dippers. The predictive value of suppressed nocturnal dipping pattern should be investigated while taking autonomic neural activity into accountenAutonomic neural activityDippersMorning blood pressure surgeNon-dippersArticle