Morning change from supine sleep to upright activity causes acute stress in arterial system, which may be measured from ABPM data as morning BP surge. High level of such stress according to Kario and co-authors independently increases risk of stroke. However, its current measurement from ABPM data is not accurate because highly variable time of individual arising is only approximately estimated from patient diary.

Objective: To create a method of accurate automatic assessment of acute morning stress in arterial system by ABPM.

Methods: Cumulative sum of HR values after subtraction of 24-h HR average was computed that gradually increases during daytime(when HR>24-hr average), decreases during nighttime and increases again during next morning forming distinct minimum at the time of individual arising and thereby allowing accurate assessment of related BP change.

This technique was implemented as combination of functions on MS Excel worksheet. Absolute difference between hourly BP averages before and after arising are automatically computed to measure morning BP surge when ABPM data are ’copy-pasted’ in predefined area of worksheet.

ABPM during 48 hours were performed in 15 men, 10 women aged 36–60 to compare reproducibility and thereby accuracy of new method to the proven method of Kario. The first-second day agreement was better for new method (Bland-Altman SD of the differences: 14,03 vs 17,01 respectively).

Conclusions: Acute morning stress in arterial system may be automatically and accurately measured from ABPM data by simple technique implemented as easy as combination of functions on MS Excel worksheet.