Abstract: 【Abstract】Objective To investigate the correlation between morning hypertension (MH) and cardiovascular and cerebrovascular events in maintenance hemodialysis (MHD) patients. Methods Ambulatory blood pressure monitoring was done in 174 MHD patients with hypertension. They were classified as MH group (n= 104) and non-MH group (n=70) based on the morning blood pressure. MH group was further classified into 3 types: sustained type, non-sustained type, and surge type. They were followed up for 2 years, and cardiovascular and cerebrovascular events were recorded. General information, mortality and the incidence of cardiovascular and cerebrovascular events were compared between the two groups. Results Compared to non-MH group, weight gain in dialysis interval, the incidence of sleep disorders, morning systolic blood pressure (MSBP), the incidence of cardiovascular and cerebrovascular events (67.3% vs. 40%) and mortality (13.5% vs. 2.9%) were significantly increased (P＜0.05) but spKt/V was significantly decreased (t =10.743, P＜0.01) in MH group. The incidence of cardiovascular and cerebrovascular events was significantly higher in sustained type (75.4%) than in surge type (66.7%) and non-sustained type (40%) (c2= 8.815, P＜0.05), but the mortality was indifferent among the 3 types in MH group (c2=0.798, P＞0.05). The value of MSBP was positively correlated with the incidence of cardiovascular and cerebrovascular events in MH group (r=0.700, P＜0.01). Conclusion MH closely correlates with the incidence of cardiovascular and cerebrovascular events in MHD patients with hypertension. MH may be an independent risk factor of cardiovascular and cerebrovaseuar events.

Key words: maintenance hemodialysis, morning hypertension, cardiovascular and cerebrovaseuar events