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Takenaka T, Kishimoto M, Ohta M, Tomonaga O, Suzuki H. Sodium-glucose co-transporter type 2 inhibitors reduce evening home blood pressure in type 2 diabetes with nephropathy. Diab Vasc Dis Res 2017; 14:258-261. [PMID: 28467199 DOI: 10.1177/1479164117690299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The effects of sodium-glucose co-transporter type 2 inhibitors on home blood pressure were examined in type 2 diabetes with nephropathy. METHODS The patients with diabetic nephropathy were screened from medical records in our hospitals. Among them, 52 patients who measured home blood pressure and started to take sodium-glucose co-transporter type 2 inhibitors were selected. Clinical parameters including estimated glomerular filtration rate, albuminuria and home blood pressure for 6 months were analysed. RESULTS Sodium-glucose co-transporter type 2 inhibitors (luseogliflozin 5 mg/day or canagliflozin 100 mg/day) reduced body weight, HbA1c, albuminuria, estimated glomerular filtration rate and office blood pressure. Although sodium-glucose co-transporter type 2 inhibitors did not alter morning blood pressure, it reduced evening systolic blood pressure. Regression analyses revealed that decreases in evening blood pressure predicted decrements in albuminuria. CONCLUSION The present data suggest that sodium-glucose co-transporter type 2 inhibitors suppress sodium overload during daytime to reduce evening blood pressure and albuminuria.
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Affiliation(s)
- Tsuneo Takenaka
- 1 Department of Medicine, International University of Health and Welfare, Clinical Research Center, Sanno Hospital, Tokyo, Japan
| | - Miyako Kishimoto
- 1 Department of Medicine, International University of Health and Welfare, Clinical Research Center, Sanno Hospital, Tokyo, Japan
| | - Mari Ohta
- 1 Department of Medicine, International University of Health and Welfare, Clinical Research Center, Sanno Hospital, Tokyo, Japan
| | | | - Hiromichi Suzuki
- 3 Department of Medicine, Musashino Tokushukai Hospital, Tokyo, Japan
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52
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Lee CJ, Park S. The Role of Home Blood Pressure Telemonitoring for Blood Pressure Control. Pulse (Basel) 2016; 4:78-84. [PMID: 27752479 DOI: 10.1159/000448375] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 07/13/2016] [Indexed: 01/13/2023] Open
Abstract
Despite improvements in hypertension awareness and treatment, the blood pressure (BP) control rate still remains at around 50%. One of the major determinants of low BP control results from therapeutic inertia of the physician and suboptimal compliance of the patients. Home BP self-measurement and monitoring improves patients' awareness and helps the management of hypertension. Recent technological advances are allowing for accurate measurement and telemonitoring of home BP, with a number of randomized clinical trials demonstrating the efficacy of telemonitoring for BP control. Home BP telemonitoring combined with self-adjustment based on prespecified treatment algorithms has been shown to improve BP control. Additionally, telemonitoring with active intervention by medical professionals has been shown to improve drug compliance and increase the target BP achievement rate. Although nothing can replace the tried and tested doctor-patient relationship in the office, telemonitoring of home BP will be an important tool for treating hypertension in the future.
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Affiliation(s)
- Chan Joo Lee
- Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sungha Park
- Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
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Hoshide S, Yano Y, Haimoto H, Yamagiwa K, Uchiba K, Nagasaka S, Matsui Y, Nakamura A, Fukutomi M, Eguchi K, Ishikawa J, Kario K. Morning and Evening Home Blood Pressure and Risks of Incident Stroke and Coronary Artery Disease in the Japanese General Practice Population. Hypertension 2016; 68:54-61. [DOI: 10.1161/hypertensionaha.116.07201] [Citation(s) in RCA: 133] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Accepted: 04/04/2016] [Indexed: 02/03/2023]
Affiliation(s)
- Satoshi Hoshide
- From the Division of Cardiovascular Medicine, Department of Medicine (S.H., M.F., K.E., K.K.) and Department of Sleep and Circadian Cardiology (S.H.), Jichi Medical University School of Medicine, Tochigi, Japan; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y.); Haimoto Clinic, Aichi, Japan (H.H.); Yamagiwa Clinic, Aichi, Japan (K.Y.); Oooka Clinic, Nagano, Japan (K.U.); Department of Medicine, Division of Diabetes, Metabolism and
| | - Yuichiro Yano
- From the Division of Cardiovascular Medicine, Department of Medicine (S.H., M.F., K.E., K.K.) and Department of Sleep and Circadian Cardiology (S.H.), Jichi Medical University School of Medicine, Tochigi, Japan; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y.); Haimoto Clinic, Aichi, Japan (H.H.); Yamagiwa Clinic, Aichi, Japan (K.Y.); Oooka Clinic, Nagano, Japan (K.U.); Department of Medicine, Division of Diabetes, Metabolism and
| | - Hajime Haimoto
- From the Division of Cardiovascular Medicine, Department of Medicine (S.H., M.F., K.E., K.K.) and Department of Sleep and Circadian Cardiology (S.H.), Jichi Medical University School of Medicine, Tochigi, Japan; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y.); Haimoto Clinic, Aichi, Japan (H.H.); Yamagiwa Clinic, Aichi, Japan (K.Y.); Oooka Clinic, Nagano, Japan (K.U.); Department of Medicine, Division of Diabetes, Metabolism and
| | - Kayo Yamagiwa
- From the Division of Cardiovascular Medicine, Department of Medicine (S.H., M.F., K.E., K.K.) and Department of Sleep and Circadian Cardiology (S.H.), Jichi Medical University School of Medicine, Tochigi, Japan; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y.); Haimoto Clinic, Aichi, Japan (H.H.); Yamagiwa Clinic, Aichi, Japan (K.Y.); Oooka Clinic, Nagano, Japan (K.U.); Department of Medicine, Division of Diabetes, Metabolism and
| | - Kiyoshi Uchiba
- From the Division of Cardiovascular Medicine, Department of Medicine (S.H., M.F., K.E., K.K.) and Department of Sleep and Circadian Cardiology (S.H.), Jichi Medical University School of Medicine, Tochigi, Japan; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y.); Haimoto Clinic, Aichi, Japan (H.H.); Yamagiwa Clinic, Aichi, Japan (K.Y.); Oooka Clinic, Nagano, Japan (K.U.); Department of Medicine, Division of Diabetes, Metabolism and
| | - Shoichiro Nagasaka
- From the Division of Cardiovascular Medicine, Department of Medicine (S.H., M.F., K.E., K.K.) and Department of Sleep and Circadian Cardiology (S.H.), Jichi Medical University School of Medicine, Tochigi, Japan; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y.); Haimoto Clinic, Aichi, Japan (H.H.); Yamagiwa Clinic, Aichi, Japan (K.Y.); Oooka Clinic, Nagano, Japan (K.U.); Department of Medicine, Division of Diabetes, Metabolism and
| | - Yoshio Matsui
- From the Division of Cardiovascular Medicine, Department of Medicine (S.H., M.F., K.E., K.K.) and Department of Sleep and Circadian Cardiology (S.H.), Jichi Medical University School of Medicine, Tochigi, Japan; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y.); Haimoto Clinic, Aichi, Japan (H.H.); Yamagiwa Clinic, Aichi, Japan (K.Y.); Oooka Clinic, Nagano, Japan (K.U.); Department of Medicine, Division of Diabetes, Metabolism and
| | - Akira Nakamura
- From the Division of Cardiovascular Medicine, Department of Medicine (S.H., M.F., K.E., K.K.) and Department of Sleep and Circadian Cardiology (S.H.), Jichi Medical University School of Medicine, Tochigi, Japan; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y.); Haimoto Clinic, Aichi, Japan (H.H.); Yamagiwa Clinic, Aichi, Japan (K.Y.); Oooka Clinic, Nagano, Japan (K.U.); Department of Medicine, Division of Diabetes, Metabolism and
| | - Motoki Fukutomi
- From the Division of Cardiovascular Medicine, Department of Medicine (S.H., M.F., K.E., K.K.) and Department of Sleep and Circadian Cardiology (S.H.), Jichi Medical University School of Medicine, Tochigi, Japan; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y.); Haimoto Clinic, Aichi, Japan (H.H.); Yamagiwa Clinic, Aichi, Japan (K.Y.); Oooka Clinic, Nagano, Japan (K.U.); Department of Medicine, Division of Diabetes, Metabolism and
| | - Kazuo Eguchi
- From the Division of Cardiovascular Medicine, Department of Medicine (S.H., M.F., K.E., K.K.) and Department of Sleep and Circadian Cardiology (S.H.), Jichi Medical University School of Medicine, Tochigi, Japan; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y.); Haimoto Clinic, Aichi, Japan (H.H.); Yamagiwa Clinic, Aichi, Japan (K.Y.); Oooka Clinic, Nagano, Japan (K.U.); Department of Medicine, Division of Diabetes, Metabolism and
| | - Joji Ishikawa
- From the Division of Cardiovascular Medicine, Department of Medicine (S.H., M.F., K.E., K.K.) and Department of Sleep and Circadian Cardiology (S.H.), Jichi Medical University School of Medicine, Tochigi, Japan; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y.); Haimoto Clinic, Aichi, Japan (H.H.); Yamagiwa Clinic, Aichi, Japan (K.Y.); Oooka Clinic, Nagano, Japan (K.U.); Department of Medicine, Division of Diabetes, Metabolism and
| | - Kazuomi Kario
- From the Division of Cardiovascular Medicine, Department of Medicine (S.H., M.F., K.E., K.K.) and Department of Sleep and Circadian Cardiology (S.H.), Jichi Medical University School of Medicine, Tochigi, Japan; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y.); Haimoto Clinic, Aichi, Japan (H.H.); Yamagiwa Clinic, Aichi, Japan (K.Y.); Oooka Clinic, Nagano, Japan (K.U.); Department of Medicine, Division of Diabetes, Metabolism and
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54
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Kindman LA, Turner JR, Lee J. Blood Pressure Measurement Modalities: A Primer for Busy Practitioners. J Clin Hypertens (Greenwich) 2016; 18:262-6. [PMID: 26558475 PMCID: PMC8032056 DOI: 10.1111/jch.12709] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
| | | | - John Lee
- Cardiovascular Center of ExcellenceQuintilesDurhamNC
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55
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Sharman JE, Blizzard L, Kosmala W, Nelson MR. Pragmatic Method Using Blood Pressure Diaries to Assess Blood Pressure Control. Ann Fam Med 2016; 14:63-9. [PMID: 26755785 PMCID: PMC4709157 DOI: 10.1370/afm.1883] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
PURPOSE Twenty-four-hour ambulatory blood pressure (ABP) is the reference standard of blood pressure control. Home blood pressure (HBP) is superior to clinic blood pressure for assessing control, but a barrier to its use is the need for physicians to calculate average blood pressure from patient diaries. We sought to develop a quick and pragmatic method to assess blood pressure control from patients' HBP diaries. METHODS Seven-day HBP and 24-hour ABP were measured in 286 patients with uncomplicated treated hypertension (aged 64 ± 8 years; 53% female). We determined the optimal ratio of home systolic blood pressure readings above threshold (≥135 mm Hg) for the last 10 recorded that would best predict elevated 24-hour ABP. Uncontrolled blood pressure was defined as 24-hour ABP systolic blood pressure ≥130 mm Hg or 24-hour ABP daytime systolic blood pressure ≥135 mm Hg. Validation by corroborative evidence was tested by association with markers of end-organ disease. RESULTS The best predictor of 24-hour ABP systolic blood pressure above treatment/target threshold was having 3 or more (≥30%) of the last 10 home systolic blood pressure readings ≥135 mm Hg (area under the receiver operating characteristic curve = 0.71). Importantly, patients meeting this criterion had evidence of target organ disease, with significantly higher aortic stiffness, left ventricular relative wall thickness, and left atrial area, and lower left ventricular ejection fraction, compared with those who did not meet this criterion. CONCLUSIONS To facilitate uptake of HBP monitoring, we propose that physicians can determine the percentage of the last 10 home systolic blood pressure values ≥135 mm Hg for a patient and tailor management accordingly.
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Affiliation(s)
- James E Sharman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Leigh Blizzard
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Wojciech Kosmala
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia Wroclaw Medical University, Wroclaw, Poland
| | - Mark R Nelson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
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56
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Studies comparing ambulatory blood pressure and home blood pressure on cardiovascular disease and mortality outcomes: a systematic review. ACTA ACUST UNITED AC 2015; 10:224-234.e17. [PMID: 26822864 DOI: 10.1016/j.jash.2015.12.013] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 12/08/2015] [Accepted: 12/16/2015] [Indexed: 12/18/2022]
Abstract
Ambulatory blood pressure monitoring (ABPM) is more commonly recommended for assessing out-of-clinic blood pressure (BP) than home blood pressure monitoring (HBPM). We conducted a systematic review to examine whether ABPM or HBPM is more strongly associated with cardiovascular disease events and/or mortality. Of 1007 abstracts published through July 20, 2015, nine articles, reporting results from seven cohorts, were identified. After adjustment for BP on HBPM, BP on ABPM was associated with an increased risk of outcomes in two of four cohorts for systolic blood pressure and two of three cohorts for diastolic blood pressure. After adjustment for BP on ABPM, systolic blood pressure on HBPM was associated with outcomes in zero of three cohorts; an association was present in one of two cohorts for diastolic blood pressure on HBPM. There is a lack of strong empiric evidence supporting ABPM or HBPM over the other approach for predicting cardiovascular events or mortality.
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57
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Aekplakorn W, Suriyawongpaisal P, Tansirisithikul R, Sakulpipat T, Charoensuk P. Effectiveness of Self-Monitoring Blood Pressure in Primary Care: A Randomized Controlled Trial. J Prim Care Community Health 2015; 7:58-64. [PMID: 26574566 DOI: 10.1177/2150131915614069] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To examine the effectiveness of self-monitoring blood pressure (SMBP) in a randomized controlled trial with 12 months of follow-up in a community hospital. METHODS A total of 224 eligible patients with hypertension were randomly allocated to the SMBP (n = 111) and usual care groups (n = 113). Each patient in the SMBP group was provided with a blood pressure (BP) monitor for home BP measurement. Mixed model regression was used to compare changes in BP at months 6 and 12 and compare between groups. RESULTS At month 12, compared with usual care, the SMBP group had average systolic BP decreased by 2.5 mm Hg. The benefit of the SMBP was found in those aged ≥60 years, which significantly decreased by -8.9 mm Hg (95% CI = -15.1 to -2.7) compared with those in the usual care. For individuals aged 60 years and older in the SMBP group, the proportion of those with uncontrolled BP decreased from 90.9% at baseline to 38.2% at month 12 (P < .05). However, among those aged <60 years, SMBP did not perform better than the usual care group. CONCLUSION For primary care setting in urban area, the SMBP resulted in lower BP in the older persons with hypertension at 12 months. Further study on effectiveness of SMBP in other settings may be warranted.
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58
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Goldstein KM, Zullig LL, Bosworth HB, Oddone EZ. Consideration of Out-of-Office Blood Pressure Monitoring in Hypertension Management. J Clin Hypertens (Greenwich) 2015; 18:381-2. [PMID: 26541118 DOI: 10.1111/jch.12729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Karen M Goldstein
- Center of Excellence for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC.,Ambulatory Care Services, Durham Veterans Affairs Medical Center, Durham, NC.,Division of General Internal Medicine, Duke University, Durham, NC
| | - Leah L Zullig
- Center of Excellence for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC.,Division of General Internal Medicine, Duke University, Durham, NC
| | - Hayden B Bosworth
- Center of Excellence for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC.,Division of General Internal Medicine, Duke University, Durham, NC.,Departments of Psychiatry and School of Nursing, Duke University, Durham, NC
| | - Eugene Z Oddone
- Center of Excellence for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC.,Ambulatory Care Services, Durham Veterans Affairs Medical Center, Durham, NC.,Division of General Internal Medicine, Duke University, Durham, NC
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59
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Maternal clinic and home blood pressure measurements during pregnancy and infant birth weight: the BOSHI study. Hypertens Res 2015; 39:151-7. [PMID: 26510783 DOI: 10.1038/hr.2015.108] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Revised: 08/12/2015] [Accepted: 09/02/2015] [Indexed: 01/05/2023]
Abstract
This prospective cohort study compared measurements of maternal home blood pressure (HBP) with clinic blood pressure (CBP) before 20 weeks' gestation to determine associations with the risk of delivering a lower birth weight infant. A total of 605 Japanese women were included. Exposures were initial CBP, made between 10 weeks 0 days and 19 weeks 0 days, and HBP for comparison made within 1 week of CBP. Outcome was infant's birth weight, categorized and ranked as follows: ⩾3500 g, 3000-3499 g, 2500-2999 g and <2500 g. The proportional odds model with possible confounding factors was applied to compare the associations between CBP and HBP on infant birth weight. When both CBP and HBP were included simultaneously, the adjusted odds ratios (ORs) per 1 standard deviation (1s.d.) increase in clinic and home diastolic BP (DBP) were 1.06 (95% confidence interval (CI): 0.87-1.30) and 1.28 (95% CI: 1.04-1.58), respectively. The adjusted ORs per 1s.d. increase in clinic and home mean arterial pressure (MAP) were 1.02 (95% CI: 0.83-1.24) and 1.29 (95% CI: 1.04-1.59), respectively. Systolic BP measurement was not associated with infant birth weight. In conclusion, high maternal home DBP and MAP before 20 weeks' gestation was associated with a higher risk of lower infant birth weight than clinic DBP and MAP. Therefore, in addition to CBP, it may be worth having pregnant women measure HBP to determine the risk of lower infant birth weight.
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60
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Shibasaki S, Hoshide S, Eguchi K, Ishikawa J, Kario K. Increase Trend in Home Blood Pressure on a Single Occasion Is Associated With B-Type Natriuretic Peptide and the Estimated Glomerular Filtration Rate. Am J Hypertens 2015; 28:1098-105. [PMID: 25631382 DOI: 10.1093/ajh/hpu295] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 12/11/2014] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Although obtaining multiple home blood pressure (HBP) measurements on a single occasion was recommended in European and Japanese hypertension guidelines, the clinical implications of the differences in BP measurements on a single occasion have been uncertain. METHODS Here, 4,149 patients with cardiovascular risk factors were enrolled. We asked the patients to measure their HBP 3 times on a single occasion each day over a 2-week period. We evaluated the target organ damage (TOD) indicators left ventricular mass index (LVMI), urinary albumin creatinine ratio, B-type natriuretic peptide (BNP), N-terminal pro-BNP (NT-pro BNP), high-sensitive cardiac troponin, brachial-ankle pulse wave velocity (ba PWV), intima-media thickness, and estimated glomerular filtration rate (eGFR). The associations between TOD and the difference between the first home systolic BP (SBP) value and the average of the second and third home SBP values were assessed by multiple regression analyses with adjustment for covariates. RESULTS Compared to the quintile median, the TOD of the first-quintile patients (i.e., those with elevated the second and third home SBP values compared to the first value) were significantly higher BNP, higher NT-pro BNP, higher ba PWV, and lower eGFR. In a univariate analysis of variance, compared to the median quintile, the first-quintile patients had independently and significantly higher BNP, higher NT-pro BNP, and lower eGFR. CONCLUSION The patients with elevated the second and third home SBP values compared to the first value taken on a single occasion were likely to have deteriorated BNP, NT-pro BNP, and eGFR.
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Affiliation(s)
- Seiichi Shibasaki
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Kazuo Eguchi
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Joji Ishikawa
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
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Parity as a factor affecting the white-coat effect in pregnant women: the BOSHI study. Hypertens Res 2015; 38:770-5. [DOI: 10.1038/hr.2015.97] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 09/04/2014] [Accepted: 09/27/2014] [Indexed: 11/08/2022]
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Eguchi K, Hoshide S, Komori T, Nagasaka S, Kario K. A New Proposal for the Target Value for Home BP in Type 2 Diabetes Patients: The J-HOP Study. Am J Hypertens 2015; 28:971-9. [PMID: 25528450 DOI: 10.1093/ajh/hpu249] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 11/07/2014] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE The target levels of home-monitored blood pressure (BP) in patients with type 2 diabetes mellitus (T2DM) have not yet been established. We sought to examine the appropriate target home BP level in T2DM. METHODS This is a subanalysis of the Japan Morning Surge-Home Blood Pressure (J-HOP) study. We enrolled 4,310 patients who had at least 1 cardiovascular risk factor, and clinic and home BP monitoring was performed. The urinary albumin-to-creatinine ratio (UACR) was measured as a marker of microvascular disease. Quadratic equations of the relationship between clinic/home systolic BP (SBP) and log-transformed UACR were used to determine the home BP value. Home BP levels corresponding to clinic SBP/diastolic BP (DBP) level using the UACR values were calculated separately by the presence/absence of diabetes. RESULTS The mean age of the patients was 64.9±10.9 years; 47.0% were males. Of the 4,310 subjects enrolled, 1,057 (24.5%) had T2DM (the DM group) and 3,253 (75.5%) did not (non-DM group). The home BP levels equivalent to clinic BP 140/90 mm Hg were 135/84 and 135/83 mm Hg in the DM and non-DM groups, respectively. The home SBP levels equivalent to clinic SBP 130/80 mm Hg were 122/79 mm Hg in the non-DM group and 129/78 mm Hg in the DM group. CONCLUSIONS Regardless of diabetic status, the home BP level that corresponds to the clinic SBP 140/90 mm Hg was 135/85 mm Hg. In patients with T2DM, the home SBP level equivalent to clinic SBP 130/80 mm Hg was 129/78 mm Hg with regard to the extent of microvascular disease.
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Affiliation(s)
- Kazuo Eguchi
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Tochigi, Japan;
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Takahiro Komori
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Shoichiro Nagasaka
- Division of Endocrinology and Metabolism, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Tochigi, Japan
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63
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Impact of depression on masked hypertension and variability in home blood pressure in treated hypertensive patients. Hypertens Res 2015; 38:751-7. [DOI: 10.1038/hr.2015.75] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 03/24/2015] [Accepted: 03/26/2015] [Indexed: 11/08/2022]
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Randomized trial comparing the velocities of the antihypertensive effects on home blood pressure of candesartan and candesartan with hydrochlorothiazide. Hypertens Res 2015; 38:701-7. [DOI: 10.1038/hr.2015.64] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 03/25/2015] [Accepted: 04/09/2015] [Indexed: 11/08/2022]
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65
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Hosaka M, Asayama K, Staessen JA, Tatsuta N, Satoh M, Kikuya M, Ohkubo T, Satoh H, Imai Y, Nakai K. Relationship between maternal gestational hypertension and home blood pressure in 7-year-old children and their mothers: Tohoku Study of Child Development. Hypertens Res 2015; 38:776-82. [PMID: 25971628 DOI: 10.1038/hr.2015.63] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2014] [Revised: 03/05/2015] [Accepted: 03/23/2015] [Indexed: 11/09/2022]
Abstract
Women who had hypertensive disorders in pregnancy have an increased risk of cardiovascular diseases in later life. No studies, however, have investigated whether maternal hypertensive disorders in pregnancy affect self-measured blood pressure at home (HBP) in mothers and their children. We evaluated the association between maternal hypertension during pregnancy and HBP based on the prospective Tohoku Study of Child Development birth cohort study, which was performed in two areas in Japan. We included children in a singleton birth at term (36-42 weeks of gestation) with a birth weight of >2400 g. We collected prenatal care data from the medical charts. Because only two mothers experienced preeclampsia, we defined gestational hypertension (GH) as a hypertensive disorder in pregnancy. Seven years after birth, mothers and their children measured their HBP in the morning for 2 weeks. Of 813 eligible mothers, 28 (3.4%) experienced GH, and those were of a similar age compared with 785 non-GH mothers (37.3 vs. 38.0 years; P=0.41). Women with GH had higher body mass index (BMI) (23.8 vs. 21.4 kg m(-)(2); P=0.01) and elevated HBP (120.3/76.8 vs. 110.4/68.6 mm Hg; P<0.0002) 7 years after delivery. However, HBP was similar in children with and without GH mothers (93.5/55.9 vs. 94.1/56.1 mm Hg, P>0.38). These results were confirmatory in case-control (1:2) analyses with matching by maternal age, maternal BMI before pregnancy, survey area and parity. In conclusion, maternal GH did not affect HBP in offspring but strongly affected maternal HBP even 7 years after birth.
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Affiliation(s)
- Miki Hosaka
- Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan
| | - Kei Asayama
- Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan.,Department of Hygiene and Public health, Teikyo University School of Medicine, Tokyo, Japan
| | - Jan A Staessen
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.,VitaK Research and Development, Maastricht University, Maastricht, The Netherlands
| | - Nozomi Tatsuta
- Department of Environmental Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Development and Environmental Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Michihiro Satoh
- Department of Pharmacy, Tohoku University Hospital, Sendai, Japan
| | - Masahiro Kikuya
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public health, Teikyo University School of Medicine, Tokyo, Japan
| | - Hiroshi Satoh
- Professor Emeritus, Tohoku University, Sendai, Japan
| | - Yutaka Imai
- Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan
| | - Kunihiko Nakai
- Department of Environmental Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Development and Environmental Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
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Tamura T, Kimura Y. Specific health checkups in Japan: The present situation analyzed using 5-year statistics and the future. Biomed Eng Lett 2015. [DOI: 10.1007/s13534-015-0172-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Randomized clinical trial to assess the effectiveness of remote patient monitoring and physician care in reducing office blood pressure. Hypertens Res 2015; 38:491-7. [DOI: 10.1038/hr.2015.32] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Revised: 01/22/2015] [Accepted: 01/26/2015] [Indexed: 01/13/2023]
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Abstract
Hypertension is the most common preventable cause of cardiovascular disease. Home blood pressure monitoring (HBPM) is a self-monitoring tool that can be incorporated into the care for patients with hypertension and is recommended by major guidelines. A growing body of evidence supports the benefits of patient HBPM compared with office-based monitoring: these include improved control of BP, diagnosis of white-coat hypertension and prediction of cardiovascular risk. Furthermore, HBPM is cheaper and easier to perform than 24-hour ambulatory BP monitoring (ABPM). All HBPM devices require validation, however, as inaccurate readings have been found in a high proportion of monitors. New technology features a longer inflatable area within the cuff that wraps all the way round the arm, increasing the 'acceptable range' of placement and thus reducing the impact of cuff placement on reading accuracy, thereby overcoming the limitations of current devices.
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Affiliation(s)
- Jacob George
- Senior Clinical Lecturer, Honorary Consultant Physician, Clinical Pharmacology/Acute Medicine, University of Dundee Medical School/NHS Tayside, Dundee, Scotland
| | - Thomas MacDonald
- Professor of Clinical Pharmacology, Medicines Monitoring Unit and Hypertension Research Centre, Division of Medical Sciences, University of Dundee, Ninewells Hospital & Medical School, Dundee, Scotland
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Mallat SG, Samra SA, Younes F, Sawaya MT. Identifying predictors of blood pressure control in the Lebanese population - a national, multicentric survey -- I-PREDICT. BMC Public Health 2014; 14:1142. [PMID: 25373466 PMCID: PMC4246605 DOI: 10.1186/1471-2458-14-1142] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 09/29/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Blood Pressure (BP) is not well controlled and factors that predict BP control are not well identified in Lebanon. Improvement of hypertension management requires an understanding of patients' characteristics and factors associated with uncontrolled BP. This national, multicentric, observational prospective study was designed to determine the predictors of BP control in patients followed up to 6 months. METHODS I-PREDICT study was conducted on 988 patients with newly diagnosed or uncontrolled hypertension. Socio-demographic and clinical characteristics were analyzed. The level of agreement between doctors' perceptions on BP control status and JNC VII guidelines was analyzed. RESULTS The predictor associated with poor BP control was diabetes (OR = 0.17, CI = 0.10-0.28 at month-1; OR = 0.15, CI = 0.10-0.24 at month-6). The predictors associated with better BP control at month-6 were the early control of BP at month-1 (OR = 10.39, CI = 6.18-17.47) and combination therapy prescribed at baseline and month-1 (OR = 15.14, CI = 1.09-208.46, P = 0.04). In the sub-group of diabetes, the predictors that were associated with better BP control at 6 months were following diet at V1 (OR = 2.27, CI = 1.01 to 5.12) and BP control at V2 (OR = 7.34, CT = 3.83 to 14.07). The predictors that were associated with poor BP control at 6 months were middle economic class (OR = 0.036, CI = 0.16-0.94) and upper economic class (OR = 0.036; CI = 0.13-0.93).The rate of BP control was significantly higher at month 6 versus month 1 (67.52% vs 44.08%, P = 0.001). Additional analysis showed poor agreement between the doctors' perceptions on BP control status and the guidelines. CONCLUSIONS Reaching an early BP control and combination therapy were significant predictors of better BP control, whereas diabetes was a significant predictor of poor BP control. A poor agreement between JNC VII guidelines and clinical practice was observed. I-PREDICT study identified factors that can be targeted for improving BP control.
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Affiliation(s)
- Samir G Mallat
- Department of Internal Medicine, American University of Beirut, Riad El-Solh, P,O, Box 11-0236, Beirut 11072020, Lebanon.
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Effectiveness of olmesartan-based treatment on home and clinic blood pressure in elderly patients with masked and white coat hypertension. Hypertens Res 2014; 38:178-85. [PMID: 25354777 PMCID: PMC4351403 DOI: 10.1038/hr.2014.156] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 07/03/2014] [Accepted: 07/16/2014] [Indexed: 01/26/2023]
Abstract
Few large-scale studies have evaluated the effectiveness of angiotensin receptor blockers in patients with masked hypertension (MH) and white coat hypertension (WCH) based on age using real-world blood pressure (BP) data. We used data from the Home BP measurement with Olmesartan Naive patients to Establish Standard Target BP (HONEST) study to investigate the effectiveness of olmesartan-based treatment by patient age (<65 years of age, n=9817; 65–74 years of age, n=6792; ⩾75 years of age, n=4732), focusing on morning home BP (strongly associated with cardiovascular disease and useful for MH and WCH diagnosis). Sixteen weeks of treatment changed morning home BP (mean systolic/diastolic) by −18.1/−9.7, −15.9/−7.4 and −14.2/−6.4 mm Hg and clinic BP by −20.1/−11.3, −17.3/−8.7 and −15.4/−7.2 mm Hg, in these age groups, respectively (P<0.0001). Pulse pressure decreased (−7.8 to −8.8 mm Hg, P<0.0001). Patients aged ⩾80 years experienced similar BP and pulse pressure changes. In patients aged ⩾75 years, mean morning and clinic BP after 16 weeks was 137.5/74.8 and 129.7/70.4 mm Hg, respectively, in MH patients and 132.3/72.2 and 139.7/72.7 mm Hg, respectively, in WCH patients. Regardless of age, only elevated clinic or home BP values decreased to target ranges. The incidence of adverse effects associated with excessive BP lowering was low in all of the age groups. In conclusion, our study suggests that olmesartan-based treatment was safe and useful for managing MH, WCH and sustained hypertension in elderly patients. The lack of a placebo group was a limitation of the study.
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Asayama K, Brguljan-Hitij J, Imai Y. Out-of-Office Blood Pressure Improves Risk Stratification in Normotension and Prehypertension People. Curr Hypertens Rep 2014; 16:478. [DOI: 10.1007/s11906-014-0478-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Postprandial hypotension detected through home blood pressure monitoring: a frequent phenomenon in elderly hypertensive patients. Hypertens Res 2013; 37:438-43. [PMID: 24108236 DOI: 10.1038/hr.2013.144] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 08/21/2013] [Accepted: 08/27/2013] [Indexed: 12/20/2022]
Abstract
Postprandial hypotension (PPH) is a frequently under-recognized entity associated with increased morbidity and mortality. The prevalence of PPH detected through home blood pressure monitoring (HBPM) is unknown. To determine the prevalence and clinical predictors of PPH in hypertensive patients assessed through HBPM. Hypertensive patients of 18 years or older underwent home blood pressure (BP) measurements (duplicate measurements for 4 days: in the morning, 1 h before and 1 h after their usual lunch, and in the evening; OMRON 705 CP). PPH was defined as a meal-induced systolic BP decrease of ≥20 mm Hg. Variables identified as relevant predictors of PPH were entered into a multivariate logistic regression analysis. In total, 230 patients were included in the analysis, with a median age of 73.6 (interquartile range 16.9) years, and 65.2% were female. The prevalence of PPH (at least one episode) was 27.4%. Four variables were independently associated with PPH: age of 80 years or older (odds ratio (OR) 3.45, 95% confidence interval (CI) 1.35-8.82), body mass index (BMI) (OR 0.88, 95%CI 0.81-0.96), office systolic BP (OR 1.03, 95%CI 1.01-1.05) and a history of cerebrovascular disease (OR 3.29, 95%CI 1.03-10.53). PPH after a typical meal is a frequent phenomenon that can be detected through HBPM. Easily measurable parameters in the office such as older age, higher systolic BP, lower BMI and a history of cerebrovascular disease may help to detect patients at risk of PPH who would benefit from HBPM.
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