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Background The exaggerated surge in ming blood pressure (BP) that many patients experience upon awakening may be closely related to target organ damage and may be a predictor of cardiovascular complications.However,no previous studies have evaluated the rate of this surge independently of the evening period.It remains unclear whether the rate of increase experienced during the surge is a significant or independent determinant of cardiovascular events.Methods We randomly selected 340 ambulatory BP monitoring (ABPM) patients.All subjects without type 2 diabetes mellitus were divided into two groups:hypertensive group (n=170) and normotensive group (n=170).We analyzed ambulatory blood pressure recordings using a double logistic curve-fitting procedure to determine whether the magnitude of the surge in BP and heart rate (HR) in the ming is related to the level of BP in hypertensive individuals.We evaluated the association between the rate of the ming surge in systolic BP (SBP) and the incidence of myocardial infarction and stroke in normotensive and hypertensive subjects.Results Comparisons between hypertensive and normotensive subjects showed that the rates of the ming surges in SBP,mean BP (MBP),and diastolic BP (DBP) were greater in the hypertensive group (P ＜0.05) than in the normotensive group.The rate of ming surge in BP was found to be correlated with the daytime SBP (r=0.236,P ＜0.01),the difference between the day and night plateau (r=0.249,P ＜0.01),and the night SBP (r=-0.160,P ＜0.05),respectively.After controlling for age,sex,and mean systolic pressure within 24 hours (24 h SBP),the rate of ming surge in SBP was closely correlated with daytime SBP (r=0.463,P ＜0.001),night SBP (r=-0.173,P ＜0.05),and the difference between the day and night plateau (r=0.267,P ＜0.001).Logistic regression analysis revealed that the rate of ming surge in SBP was an independent determinant of myocardial infarction (OR=1.266,95％ CI=1.153-1.389,P ＜0.001) and stroke (OR=1.367,95％ CI=1.174-1.591,P ＜0.001).Conclusions The rate of the ming surge in BP is greater in hypertensive subjects than in normotensive subjects.Daytime SBP may be the best predictor of the rate of ming surge in SBP.The rate of the ming surge in BP is associated with cardiovascular and stroke events.