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Hoshide S, Kubota K, Kario K. Difference between morning and evening blood pressure at home and nocturnal hypoxia in the general practitioner-based J-HOP study. Hypertens Res 2023; 46:751-755. [PMID: 36207529 DOI: 10.1038/s41440-022-01054-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/20/2022] [Accepted: 09/01/2022] [Indexed: 01/17/2023]
Abstract
The aim of this study was to determine the independent association of nocturnal hypoxia with morning minus evening home blood pressure (MEdif) in a cohort of outpatients with at least one cardiovascular risk. A total of 1053 participants underwent home blood pressure (BP) portable pulse oximetry measurements, and 147 (14%) had an MEdif ≥20 mmHg, where MEdif was defined as the difference between morning and evening home systolic BP. When participants were divided into quartiles according to the lowest oxygen saturation (SpO2) during the nighttime, those in the lowest quartile (range, 54-79%) were significantly more likely to have MEdif ≥20 mmHg than those in the top quartile (range, 89-97%) (adjusted odds ratio, 1.98; 95% confidence interval, 1.13-3.49). The present study revealed an association between lowest SpO2 during the nighttime and increased MEdif in a cohort of outpatients with at least one cardiovascular risk.
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Affiliation(s)
- Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Kana Kubota
- Division of Cardiovascular Medicine, 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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2
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Imai Y. A personal history of research on hypertension From an encounter with hypertension to the development of hypertension practice based on out-of-clinic blood pressure measurements. Hypertens Res 2022; 45:1726-1742. [PMID: 36075990 DOI: 10.1038/s41440-022-01011-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/15/2022] [Accepted: 07/21/2022] [Indexed: 11/09/2022]
Abstract
In the 1970s, many people had severe hypertension and related cardiovascular and cerebrovascular diseases; however, antihypertensive treatments were not available at the time. The author encountered such conditions during the initial exposure to medicine. The author subsequently entered the field of hypertension medicine to prevent such conditions and engaged in hypertension research for more than 50 years. The author's central interest was the physiological and clinical aspects of blood pressure (BP) variability. Out-of-clinic BP measurements were the focus of clinical research. It was anticipated that self-measurement of BP at home (HBP) would improve medical practice surrounding hypertension. To establish evidence-based hypertension medicine, the Ohasama study (an epidemiology based on HBP) was conducted. The study provided firm evidence of the clinical significance of HBP and diagnostic criteria for hypertension and normotension. To establish target HBP levels for antihypertensive therapy, the Hypertension Objective treatment based on Measurement by Electrical Devices of Blood Pressure (HOMED-BP) study (a prospective intervention study) was also conducted. Application of HBP measurements expanded to obstetric, clinical pharmacology, pathophysiology, and genetic studies. During these studies, crucial information on the clinical significance of BP variability (such as circadian and day-by-day variation of BP, nocturnal BP, white-coat hypertension, and masked hypertension) was established. Finally, the author described the priority of HBP over clinic-measured BP for the diagnosis of hypertension in the 2014 Japanese Society of Hypertension Guidelines. In this article, the author's history of hypertension research, from the first encounter with hypertension to the construction of guidelines on hypertension, is reviewed.
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Affiliation(s)
- Yutaka Imai
- Tohoku Institute for the Management of Blood Pressure, Sendai, Japan. .,Emeritus Professor Tohoku University, Sendai, Japan.
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Uchida S, Kikuya M, Asayama K, Ohata C, Kimura T, Tatsumi Y, Nomura K, Imai Y, Ohkubo T. Predictive power of home blood pressure in the evening compared with home blood pressure in the morning and office blood pressure before treatment and in the on-treatment follow-up period: a post hoc analysis of the HOMED-BP study. Hypertens Res 2022; 45:722-729. [PMID: 35177788 DOI: 10.1038/s41440-022-00860-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 11/10/2021] [Accepted: 01/13/2022] [Indexed: 01/10/2023]
Abstract
The predictive power of home blood pressure (BP) in the evening compared with home BP in the morning and office BP has been controversial. The predictive power of evening BP was compared to that of morning BP and office BP. The likelihood ratio test between one model containing a single BP index with traditional risk factors and a similar model further containing another BP index was used to assess whether the additional BP index significantly improved the adequacy of the model. Of 3266 patients with mild-to-moderate hypertension who were on antihypertensive medications (men 50.6%, age 59.5 ± 10.0 years), 58 experienced a major adverse cardiovascular event during a median follow-up of 7.1 years. The hazard ratios for a one standard deviation increment of evening home systolic/diastolic BP were 1.26 (0.98-1.62)/1.43 (1.09-1.88) in the baseline untreated period and 1.46 (1.17-1.81)/1.63 (1.26-2.11) during the on-treatment follow-up period. When evening BP at baseline and that during follow-up were included in the same model, only the latter significantly improved the prediction models (P = 0.006/0.005 for systolic/diastolic BP). Then, evening home BP vs. morning BP during follow-up was tested. The former did not improve the prediction models (P > 0.2), but the latter significantly improved the models (P ≤ 0.048). Similarly, when evening home BP and office BP during follow-up were analyzed, only the former significantly improved the prediction models (P ≤ 0.015). In conclusion, evening BP could be a more potent predictor than office BP, but it was inferior compared to morning BP in the treatment of mild-to-moderate hypertensive patients.
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Affiliation(s)
- Shinya Uchida
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Masahiro Kikuya
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan. .,Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.
| | - Kei Asayama
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.,Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Cardiovascular Sciences, Leuven, Belgium.,Tohoku Institute for Management of Blood Pressure, Sendai, Japan
| | - Chiaki Ohata
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Takahiro Kimura
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.,Fourth Department of Internal Medicine, Mizonokuchi Hospital, Teikyo University School of Medicine, Kawasaki, Japan
| | - Yukako Tatsumi
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Kyoko Nomura
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.,Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Yutaka Imai
- Tohoku Institute for Management of Blood Pressure, Sendai, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.,Tohoku Institute for Management of Blood Pressure, Sendai, Japan
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Association between urinary sodium-to-potassium ratio and home blood pressure and ambulatory blood pressure: the Ohasama study. J Hypertens 2022; 40:862-869. [PMID: 35165245 DOI: 10.1097/hjh.0000000000003087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE No studies have demonstrated the association between urinary sodium-to-potassium (Na/K) ratio and all out-of-office blood pressure (BP) [home morning and evening BP (self-measured at home), and 24-h, daytime, and night-time ambulatory BP] in the same cohort. We aimed to assess, which type of out-of-office BP is more strongly associated with urinary Na/K ratio in the general population. METHODS This cross-sectional study was conducted in the general population of Ohasama, Japan. Home and ambulatory BP levels were measured, and 24-h urine samples were obtained from 875 participants (men, 25.5%; mean age, 60.1 years). The urinary Na/K ratio in the 24-h urine samples was calculated. RESULTS The median (interquartile range) urinary Na/K ratio was 4.19 (3.36-5.26). Significant positive trends of home morning, home evening, 24-h, and daytime SBP were observed across quartiles of urinary Na/K ratio (trend P ≤ 0.041; adjusted mean values between Q1 and Q4 of urinary Na/K ratio: 121.0-125.5 mmHg for home morning, 120.1-123.8 mmHg for home evening, 121.6-123.4 mmHg for 24-h, 127.5-129.5 mmHg for daytime). Urinary Na/K ratio was not significantly associated with office or night-time SBP and nocturnal BP fall (trend P ≥ 0.13). In the model with both home morning or evening SBP and daytime SBP, only home SBP was significantly associated with urinary Na/K ratio (P ≤ 0.048 for home SBP). CONCLUSION These findings suggest that urinary Na/K ratio might be more strongly associated with home BP than with 24-h and daytime BP but was not associated with night-time BP.
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Sueta D, Yamamoto E, Usuku H, Suzuki S, Nakamura T, Matsui K, Akasaka T, Shiosakai K, Sugimoto K, Tsujita K. Rationale and Design of the Efficacy and Safety of Esaxerenone in Hypertensive Patients With Left Ventricular Hypertrophy (ESES-LVH) Study ― Protocol for a Multicenter, Open-Label, Exploratory Interventional Study ―. Circ Rep 2022; 4:99-104. [PMID: 35178486 PMCID: PMC8811229 DOI: 10.1253/circrep.cr-21-0122] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 12/07/2021] [Accepted: 01/01/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Daisuke Sueta
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kumamoto University
| | - Eiichiro Yamamoto
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kumamoto University
| | - Hiroki Usuku
- Center for Metabolic Regulation of Healthy Aging, Graduate School of Medical Science, Kumamoto University
| | - Satoru Suzuki
- Center for Metabolic Regulation of Healthy Aging, Graduate School of Medical Science, Kumamoto University
| | - Taishi Nakamura
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kumamoto University
| | - Kunihiko Matsui
- Community, Family, and General Medicine, Faculty of Life Sciences, Graduate School of Medical Science, Kumamoto University
| | | | | | | | - Kenichi Tsujita
- Center for Metabolic Regulation of Healthy Aging, Graduate School of Medical Science, Kumamoto University
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Narita K, Hoshide S, Kario K. Difference between morning and evening home blood pressure and cardiovascular events: the J-HOP Study (Japan Morning Surge-Home Blood Pressure). Hypertens Res 2021; 44:1597-1605. [PMID: 34321616 DOI: 10.1038/s41440-021-00686-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 05/06/2021] [Accepted: 05/11/2021] [Indexed: 11/09/2022]
Abstract
Little is known about the relationship of the difference between morning and evening systolic blood pressure (BP) (MEdif) in home BP with cardiovascular disease (CVD) incidence. To assess this relationship, we used data from the nationwide practice-based J-HOP (Japan Morning Surge-Home BP) study, which recruited 4258 cardiovascular risk participants (mean age 64.9 years; 46.8% men; 79.2% using antihypertensive medications) who underwent morning and evening home BP monitoring using a validated, automated device for 14 consecutive days. During a mean ± SD follow-up of 6.2 ± 3.8 years (26,295 person-years), 269 CVD events occurred. Adjusted Cox models suggested that higher MEdif (≥20 mmHg) was associated with higher CVD risks than was medium MEdif (0-20 mmHg) independent of the average morning and evening (MEave) home systolic BP (SBP) (adjusted hazard ratio [HR]: 1.40; 95% confidence interval [CI] 1.02-1.91). We also divided participants into four BP phenotype groups as follows: "both non-elevated" (MEdif < 20 mmHg and MEave SBP < 135 mmHg), "elevated-MEdif" (MEdif ≥ 20 mmHg and MEave SBP < 135 mmHg), "elevated-MEave" (MEdif < 20 mmHg and MEave SBP ≥ 135 mmHg), and "both elevated" (MEdif ≥ 20 mmHg and MEave SBP ≥ 135 mmHg). The cumulative incidence of CVD events was higher in patients with the "elevated-MEdif," "elevated-MEave," and "both elevated" phenotypes than in those with the "both non-elevated" phenotype. After adjusting for covariates, the "both elevated" phenotype was associated with higher CVD risk than the "both non-elevated" phenotype (adjusted HR: 1.64; 95% CI: 1.09-2.46). This is the first study demonstrating a direct correlation between CVD outcomes and the difference between morning and evening home SBP.
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Affiliation(s)
- Keisuke Narita
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.,Department of Cardiology, Karatsu Red Cross Hospital, Saga, Japan
| | - Satoshi Hoshide
- 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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de Heus RAA, Reumers SFI, van der Have A, Tumelaire M, Tully PJ, Claassen JAHR. Day-to-Day Home Blood Pressure Variability is Associated with Cerebral Small Vessel Disease Burden in a Memory Clinic Population. J Alzheimers Dis 2021; 74:463-472. [PMID: 32039855 PMCID: PMC7175928 DOI: 10.3233/jad-191134] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND High visit-to-visit blood pressure variability (BPV) has been associated with cognitive decline and cerebral small vessel disease (cSVD), in particular cerebrovascular lesions. Whether day-to-day BPV also relates to cSVD has not been investigated. OBJECTIVE To investigate the cross-sectional association between day-to-day BPV and total cSVD MRI burden in older memory clinic patients. METHODS We included outpatients referred to our memory clinic, who underwent cerebral MRI as part of their diagnostic assessment. We determined the validated total cSVD score (ranging from 0-4) by combining four markers of cSVD that were visually rated. Home blood pressure (BP) measurements were performed for one week, twice a day, according to international guidelines. BPV was defined as the within-subject coefficient of variation (CV; standard deviation/mean BP*100). We used multivariable ordinal logistic regression analyses adjusted for age, sex, smoking, diabetes, antihypertensive medication, history of cardiovascular disease, and mean BP. RESULTS For 82 patients (aged 71.2±7.9 years), mean home BP was 140/79±15/9 mmHg. Dementia and mild cognitive impairment were diagnosed in 46% and 34%, respectively. 78% had one or more markers of cSVD. Systolic CV was associated with cSVD burden (adjusted odds ratio per point increase in CV = 1.29, 95% confidence interval = 1.04-1.60, p = 0.022). There were no differences in diastolic CV and mean BP between the cSVD groups. When we differentiated between morning and evening BP, only evening BPV remained significantly associated with total cSVD burden. CONCLUSION Day-to-day systolic BPV is associated with cSVD burden in memory clinic patients. Future research should indicate whether lowering BPV should be included in BP management in older people with memory complaints.
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Affiliation(s)
- Rianne A A de Heus
- Radboud University Medical Center, Donders Institute for Brain Cognition and Behaviour, Department of Geriatric Medicine, Radboudumc Alzheimer Center, Nijmegen, The Netherlands
| | - Stacha F I Reumers
- Radboud University Medical Center, Donders Institute for Brain Cognition and Behaviour, Department of Geriatric Medicine, Radboudumc Alzheimer Center, Nijmegen, The Netherlands
| | - Alba van der Have
- Radboud University Medical Center, Donders Institute for Brain Cognition and Behaviour, Department of Geriatric Medicine, Radboudumc Alzheimer Center, Nijmegen, The Netherlands
| | - Maxime Tumelaire
- Radboud University Medical Center, Donders Institute for Brain Cognition and Behaviour, Department of Geriatric Medicine, Radboudumc Alzheimer Center, Nijmegen, The Netherlands
| | | | - Jurgen A H R Claassen
- Radboud University Medical Center, Donders Institute for Brain Cognition and Behaviour, Department of Geriatric Medicine, Radboudumc Alzheimer Center, Nijmegen, The Netherlands
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Barochiner J, Martínez R, Aparicio LS. Novel Indices of Home Blood Pressure Variability and Hypertension-Mediated Organ Damage in Treated Hypertensive Patients. High Blood Press Cardiovasc Prev 2021; 28:365-372. [PMID: 33881750 PMCID: PMC8058582 DOI: 10.1007/s40292-021-00453-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/13/2021] [Indexed: 01/02/2023] Open
Abstract
INTRODUCTION Although multiple home blood pressure variability (HBPV) indices have been proposed, the superiority of one over another is not clear in treated hypertensives. AIM We evaluated the correlation between different indices of HBPV and hypertension-mediated organ damage (HMOD) in this population and determined predictors of greater HBPV. METHODS We included adult treated hypertensives who performed an HBP monitoring (duplicate sitting BP readings in the morning, afternoon, and evening for 4 days, Omron HEM-705CP-II), laboratory measurements, transthoracic echocardiogram and carotid-femoral pulse wave velocity. We selected HBPV indices from three different calculation approaches: coefficient of variation (CoV), difference between maximum and minimum BP (MMD), and morning BP increase (MI), and evaluated their correlation with left ventricular mass index, relative wall thickness (RWT), ejection fraction, arterial stiffness and estimated glomerular filtration rate through a correlation matrix. For those variability indices significantly associated with HMOD, we constructed multiple linear regression models to determine independent predictors of HBPV. RESULTS We included 204 patients, mean age 67.2 (± 13.8) years, 64% female. CoV and MMD for systolic BP showed the greatest correlation with HMOD. Factors independently associated both with CoV and MMD were: older age (b = 0.07; 95% CI 0.04-0.07; p < 0.001 and b = 0.4; 95% CI 0.2-0.5; p < 0.001, respectively), history of stroke (b = 3.6; 95% CI 0.9-6.4; p = 0.01 and b = 25.7; 95% CI 10.1-41.2; p = 0.001, respectively), and body mass index [b = - 0.1; 95% CI - 0.2 to (- 0.02); p = 0.01 and b = - 0.5; 95% CI - 0.9 to (- 0.1); p = 0.01, respectively]. CONCLUSION CoV and MMD showed the greatest association with HMOD in treated hypertensives. Older age, history of stroke and lower body mass index were easy-to-detect predictors.
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Affiliation(s)
- Jessica Barochiner
- Hypertension Section, Internal Medicine Department, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190, C1199ABB, Buenos Aires, Argentina. .,Instituto de Medicina Traslacional e Ingeniería Biomédica (IMTIB), UE de triple dependencia CONICET-Instituto Universitario del Hospital Italiano (IUHI)-Hospital Italiano (HIBA), Buenos Aires, Argentina.
| | - Rocío Martínez
- Hypertension Section, Internal Medicine Department, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190, C1199ABB, Buenos Aires, Argentina.,Instituto de Medicina Traslacional e Ingeniería Biomédica (IMTIB), UE de triple dependencia CONICET-Instituto Universitario del Hospital Italiano (IUHI)-Hospital Italiano (HIBA), Buenos Aires, Argentina
| | - Lucas S Aparicio
- Hypertension Section, Internal Medicine Department, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190, C1199ABB, Buenos Aires, Argentina
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Noriega de la Colina A, Badji A, Robitaille-Grou MC, Gagnon C, Boshkovski T, Lamarre-Cliche M, Joubert S, Gauthier CJ, Bherer L, Cohen-Adad J, Girouard H. Associations Between Relative Morning Blood Pressure, Cerebral Blood Flow, and Memory in Older Adults Treated and Controlled for Hypertension. Hypertension 2021; 77:1703-1713. [PMID: 33775122 DOI: 10.1161/hypertensionaha.120.16124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Adrián Noriega de la Colina
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), Montreal, QC, Canada (A.N.C. A.B., M.-C.R.-G., C.G., L.B., J.C.-A., H.G.).,Department of Biomedical Sciences, Faculty of Medicine (A.N.C.), Université de Montreal, QC, Canada.,Montreal Heart Institute (MHI), Montreal, QC, Canada (A.N.C., C.G., C.J.G., L.B.).,Groupe de Recherche sur le Système Nerveux Central (GRSNC) (A.N.C., A.B., J.C.-A., H.G.).,Centre interdisciplinaire de recherche sur le cerveau et l'apprentissage (CIRCA) (A.N.C., A.B., H.G.)
| | - Atef Badji
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), Montreal, QC, Canada (A.N.C. A.B., M.-C.R.-G., C.G., L.B., J.C.-A., H.G.).,Department of Neurosciences, Faculty of Medicine (A.B.), Université de Montreal, QC, Canada.,NeuroPoly Laboratory, Institute of Biomedical Engineering, Polytechnique Montréal, QC, Canada (A.B., T.B., J.C.-A.).,Groupe de Recherche sur le Système Nerveux Central (GRSNC) (A.N.C., A.B., J.C.-A., H.G.).,Centre interdisciplinaire de recherche sur le cerveau et l'apprentissage (CIRCA) (A.N.C., A.B., H.G.)
| | - Marie-Christine Robitaille-Grou
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), Montreal, QC, Canada (A.N.C. A.B., M.-C.R.-G., C.G., L.B., J.C.-A., H.G.)
| | - Christine Gagnon
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), Montreal, QC, Canada (A.N.C. A.B., M.-C.R.-G., C.G., L.B., J.C.-A., H.G.).,Montreal Heart Institute (MHI), Montreal, QC, Canada (A.N.C., C.G., C.J.G., L.B.)
| | - Tommy Boshkovski
- NeuroPoly Laboratory, Institute of Biomedical Engineering, Polytechnique Montréal, QC, Canada (A.B., T.B., J.C.-A.)
| | - Maxime Lamarre-Cliche
- Institut de Recherches Cliniques de Montreal (IRCM) (M.L.-C.), Université de Montreal, QC, Canada
| | - Sven Joubert
- Department of Psychology, Faculty of Arts and Sciences (S.J.), Université de Montreal, QC, Canada
| | - Claudine J Gauthier
- Department of Physics (C.J.G.), Concordia University, Montreal, QC, Canada.,PERFORM Centre (C.J.G.), Concordia University, Montreal, QC, Canada
| | - Louis Bherer
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), Montreal, QC, Canada (A.N.C. A.B., M.-C.R.-G., C.G., L.B., J.C.-A., H.G.).,Department of Medicine, Faculty of Medicine (L.B.), Université de Montreal, QC, Canada.,Montreal Heart Institute (MHI), Montreal, QC, Canada (A.N.C., C.G., C.J.G., L.B.)
| | - Julien Cohen-Adad
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), Montreal, QC, Canada (A.N.C. A.B., M.-C.R.-G., C.G., L.B., J.C.-A., H.G.).,NeuroPoly Laboratory, Institute of Biomedical Engineering, Polytechnique Montréal, QC, Canada (A.B., T.B., J.C.-A.).,Groupe de Recherche sur le Système Nerveux Central (GRSNC) (A.N.C., A.B., J.C.-A., H.G.)
| | - Hélène Girouard
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), Montreal, QC, Canada (A.N.C. A.B., M.-C.R.-G., C.G., L.B., J.C.-A., H.G.).,Department of Pharmacology and Physiology, Faculty of Medicine (H.G.), Université de Montreal, QC, Canada.,Groupe de Recherche sur le Système Nerveux Central (GRSNC) (A.N.C., A.B., J.C.-A., H.G.).,Centre interdisciplinaire de recherche sur le cerveau et l'apprentissage (CIRCA) (A.N.C., A.B., H.G.)
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10
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The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2019). Hypertens Res 2020; 42:1235-1481. [PMID: 31375757 DOI: 10.1038/s41440-019-0284-9] [Citation(s) in RCA: 1091] [Impact Index Per Article: 272.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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11
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Recent status of self-measured home blood pressure in the Japanese general population: a modern database on self-measured home blood pressure (MDAS). Hypertens Res 2020; 43:1403-1412. [PMID: 32753754 DOI: 10.1038/s41440-020-0530-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 05/31/2020] [Accepted: 06/03/2020] [Indexed: 12/17/2022]
Abstract
Despite the clinical usefulness of self-measured home blood pressure (BP), reports on the characteristics of home BP have not been sufficient and have varied due to the measurement conditions in each study. We constructed a database on self-measured home BP, which included five Japanese general populations as subdivided aggregate data that were clustered and meta-analyzed according to sex, age category, and antihypertensive drug treatment at baseline (treated and untreated). The self-measured home BPs were collected after a few minutes of rest in a sitting position: (1) the morning home BP was measured within 1 h of waking, after urination, before breakfast, and before taking antihypertensive medication (if any); and (2) the evening home BP was measured just before going to bed. The pulse rate was simultaneously measured. Eligible data from 2000 onward were obtained. The morning BP was significantly higher in treated participants than in untreated people of the same age category, and the BP difference was more marked in women. Among untreated residents, home systolic/diastolic BPs measured in the morning were higher than those measured in the evening; the differences were 5.7/5.0 mmHg in women (ranges across the cohorts, 5.3-6.8/4.7-5.4 mmHg) and 7.3/7.7 mmHg in men (ranges, 6.4-8.5/7.0-8.7 mmHg). In contrast, the home pulse rate in women and men was 2.4 (range, 1.5-3.7) and 5.6 (range, 4.6-6.6) beats per minute, respectively, higher in the evening than in the morning. We demonstrated the current status of home BP and home pulse rate in relation to sex, age, and antihypertensive treatment status in the Japanese general population. The approach by which fine-clustered aggregate statistics were collected and integrated could address practical issues raised in epidemiological research settings.
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Abstract
OBJECTIVE Orthostatic hypotension is a common condition associated with adverse cardiovascular and cognitive prognosis. Screening for orthostatic hypotension consists of blood pressure measurements in supine (or sitting) and standing position during clinical consultations. As orthostatic hypotension is a poorly reproducible clinical condition, it is likely that the simple measurement carried out during consultations underestimates the true prevalence of the condition. The objective of this study is, therefore, to determine whether screening for orthostatic hypotension with home blood pressure measurements (HBPM) may improve orthostatic hypotension diagnosis without compromising the quality of the blood pressure readings. MATERIALS AND METHODS We asked all patients with indications for HBPM in the hypertension unit and in a general medical practice to perform a series of home blood pressure measurements, ending each series with a measurement in standing position. RESULTS We recruited 505 patients of mean age 68 years of which 93% were hypertensive patients. The success rate of HBPM complying with the ESH criteria (12 out of 18 measurements) was 94.5%, which is comparable with previously published series of measurements. Ninety-one percent of patients measured their blood pressure at least once in standing position, and 88% of patients recorded all six standing measurements. Orthostatic hypotension prevalence defined as the presence of one episode of orthostatic hypotension was 37.47%, much higher than orthostatic hypotension prevalence measured in the same cohort in a clinic setting (15%). CONCLUSION The measurement of blood pressure in standing position during HBPM is feasible without altering the quality of the blood pressure readings in seated position. Our findings show that orthostatic hypotension is significantly more often detected at home by the patient than at the doctor's office, which may allow quicker initiation of preventive and therapeutic strategies.
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13
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Wang MC, Tseng CC, Tsai WC, Huang JJ. Blood Pressure and Left Ventricular Hypertrophy in Patients on Different Peritoneal Dialysis Regimens. Perit Dial Int 2020. [DOI: 10.1177/089686080102100106] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Objective To examine the relation between the results of ambulatory 24-hour blood pressure monitoring (ABPM) and left ventricular mass index (LVMI), then to find the independent determinant for left ventricular hypertrophy (LVH) in peritoneal dialysis (PD) patients. Finally, to evaluate the differences in the clinical and cardiovascular characteristics between patients on continuous ambulatory PD (CAPD) and continuous cyclic PD (CCPD). Design An open, nonrandomized, cross-sectional study. Setting Divisions of nephrology and cardiology in a medical center. Patients Thirty-two uremic patients on maintenance PD therapy (22 patients on CAPD, and 10 on CCPD) without anatomical heart disease or history of receiving long-term hemodialysis. Interventions Home blood pressure (BP) and office BP were measured using the Korotkoff sound technique by sphygmomanometer. ABPM was employed for continuous measurement of BP. Echocardiography was performed for measurement of cardiac parameters and calculation of LVMI. Main Outcome Measures Multivariate logistic regression analysis was performed for independent determinant of LVH in PD patients. The differences in clinical and cardiovascular characteristics between CAPD and CCPD patients were compared. Results Simple regression analysis showed positive correlations between LVMI and the duration of hypertension, ambulatory nighttime BP/BP load/BP load > 30%, serum phosphate, calcium–phosphate product, ultrafiltration (UF) volume, and percentage of UF volume during the nighttime. A negative correlation was noted between LVMI and dipping. In multiple regression analysis, the duration of hypertension was the only variable linked to LVMI. In multivariate logistic regression analysis, only ambulatory nighttime systolic BP load > 30% had an independent association with LVH. There were correlations between office/home BP and ambulatory 24-hour BP. In addition, CCPD patients had higher LVMI, UF volume during the nighttime, and percentage of UF volume during the nighttime than those of CAPD patients. Conclusions In this study, ambulatory nighttime systolic BP load > 30% had an independent association with LVH. Office and home BP measurements were correlated with ABPM in PD patients. The result that CCPD patients had a higher LVMI than CAPD patients may be due to a relative volume overload during the daytime in CCPD patients.
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Affiliation(s)
- Ming-Cheng Wang
- Divisions of Nephrology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, Republic of China
| | - Chin-Chung Tseng
- Divisions of Nephrology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, Republic of China
| | - Wei-Chuan Tsai
- and Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, Republic of China
| | - Jeng-Jong Huang
- Divisions of Nephrology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, Republic of China
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14
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Satoh M, Metoki H, Asayama K, Murakami T, Inoue R, Tsubota-Utsugi M, Matsuda A, Hirose T, Hara A, Obara T, Kikuya M, Nomura K, Hozawa A, Imai Y, Ohkubo T. Age-Related Trends in Home Blood Pressure, Home Pulse Rate, and Day-to-Day Blood Pressure and Pulse Rate Variability Based on Longitudinal Cohort Data: The Ohasama Study. J Am Heart Assoc 2019; 8:e012121. [PMID: 31333055 PMCID: PMC6761623 DOI: 10.1161/jaha.119.012121] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background Home blood pressure is a more accurate prognosticator than office blood pressure and allows the observation of day-to-day blood pressure variability. Information on blood pressure change during the life course links the prediction of blood pressure elevation with age. We prospectively assessed age-related trends in home blood pressure, home pulse rate, and their day-to-day variability evaluated as a coefficient of variation. Methods and Results We examined 1665 participants (men, 36.0%; mean age, 56.2 years) from the general population of Ohasama, Japan. A repeated-measures mixed linear model was used to estimate the age-related trends. In a mean of 15.9 years, we observed 5438 points of measurements including those at baseline. The home systolic blood pressure linearly increased with age and was higher in men than in women aged <70 years. There was an inverse-U-shaped age-related trend in home diastolic blood pressure. The day-to-day home systolic blood pressure linearly increased with age in individuals aged >40 years. However, an U-shaped age-related trend in day-to-day diastolic blood pressure variability with the nadir point at 65 to 69 years of age was observed. No significant sex differences in the day-to-day blood pressure variability were observed (P≥0.22). The average and day-to-day variability of home pulse rate decreased with age but were lower and higher, respectively, in men than in women. Conclusions The current descriptive data are needed to predict future home blood pressure and pulse rate. The data also provide information on the mechanism of day-to-day blood pressure and pulse rate variability.
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Affiliation(s)
- Michihiro Satoh
- Division of Public Health, Hygiene and Epidemiology Faculty of Medicine Tohoku Medical and Pharmaceutical University Sendai Japan
| | - Hirohito Metoki
- Division of Public Health, Hygiene and Epidemiology Faculty of Medicine Tohoku Medical and Pharmaceutical University Sendai Japan.,Department of Community Medical Supports Tohoku Medical Megabank Organization Tohoku University Sendai Japan.,Tohoku Institute for Management of Blood Pressure Sendai Japan
| | - Kei Asayama
- Tohoku Institute for Management of Blood Pressure Sendai Japan.,Department of Hygiene and Public Health Teikyo University School of Medicine Tokyo Japan
| | - Takahisa Murakami
- Division of Public Health, Hygiene and Epidemiology Faculty of Medicine Tohoku Medical and Pharmaceutical University Sendai Japan.,Division of Aging and Geriatric Dentistry Department of Oral Function and Morphology Tohoku University Graduate School of Dentistry Sendai Japan
| | - Ryusuke Inoue
- Department of Medical Information Technology Center Tohoku University Hospital Sendai Japan
| | - Megumi Tsubota-Utsugi
- Department of Hygiene and Preventive Medicine Iwate Medical University School of Medicine Iwate Japan
| | - Ayako Matsuda
- Department of Hygiene and Public Health Teikyo University School of Medicine Tokyo Japan
| | - Takuo Hirose
- Division of Nephrology and Endocrinology Faculty of Medicine Tohoku Medical and Pharmaceutical University Sendai Japan
| | - Azusa Hara
- Division of Drug Development and Regulatory Science Faculty of Pharmacy Keio University Tokyo Japan
| | - Taku Obara
- Department of Preventive Medicine and Epidemiology Tohoku Medical Megabank Organization Tohoku University Sendai Japan.,Department of Pharmaceutical Sciences Tohoku University Hospital Sendai Japan
| | - Masahiro Kikuya
- Department of Preventive Medicine and Epidemiology Tohoku Medical Megabank Organization Tohoku University Sendai Japan.,Department of Hygiene and Public Health Teikyo University School of Medicine Tokyo Japan
| | - Kyoko Nomura
- Department of Public Health Akita University Graduate School of Medicine Akita Japan
| | - Atsushi Hozawa
- Department of Preventive Medicine and Epidemiology Tohoku Medical Megabank Organization Tohoku University Sendai Japan
| | - Yutaka Imai
- Tohoku Institute for Management of Blood Pressure Sendai Japan
| | - Takayoshi Ohkubo
- Tohoku Institute for Management of Blood Pressure Sendai Japan.,Department of Hygiene and Public Health Teikyo University School of Medicine Tokyo Japan
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15
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Hodgkinson JA, Stevens R, Grant S, Mant J, Bray EP, Hobbs FDR, Martin U, Schwartz C, McCartney D, O’Mahony R, Perera-Salazar R, Roberts N, Stevens S, Williams B, McManus RJ. Schedules for Self-monitoring Blood Pressure: A Systematic Review. Am J Hypertens 2019; 32:350-364. [PMID: 30668627 PMCID: PMC6420684 DOI: 10.1093/ajh/hpy185] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 11/22/2018] [Accepted: 12/18/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Self-monitoring of blood pressure better predicts prognosis than clinic measurement, is popular with patients, and endorsed in hypertension guidelines. However, there is uncertainty over the optimal self-monitoring schedule. We therefore aimed to determine the optimum schedule to predict future cardiovascular events and determine "true" underlying blood pressure. METHODS Six electronic databases were searched from November 2009 (updating a National Institute for Health and Care Excellence [NICE] systematic review) to April 2017. Studies that compared aspects of self-monitoring schedules to either prognosis or reliability/reproducibility in hypertensive adults were included. Data on study and population characteristics, self-monitoring regime, and outcomes were extracted by 2 reviewers independently. RESULTS From 5,164 unique articles identified, 25 met the inclusion criteria. Twelve studies were included from the original NICE review, making a total of 37 studies. Increasing the number of days of measurement improved prognostic power: 72%-91% of the theoretical maximum predictive value (asymptotic maximum hazard ratio) was reached by 3 days and 86%-96% by 7 days. Increasing beyond 3 days of measurement did not result in better correlation with ambulatory monitoring. There was no convincing evidence that the timing or number of readings per day had an effect, or that ignoring the first day's measurement was necessary. CONCLUSIONS Home blood pressure should be measured for 3 days, increased to 7 only when mean blood pressure is close to a diagnostic or treatment threshold. Other aspects of a monitoring schedule can be flexible to facilitate patient uptake of and adherence with self-monitoring.
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Affiliation(s)
- James A Hodgkinson
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Richard Stevens
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Sabrina Grant
- School of Clinical Sciences, University of Bristol, Bristol, UK
| | - Jonathan Mant
- Primary Care Unit, Strangeways Research Laboratory, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Emma P Bray
- Stroke Research Unit. School of Nursing, University of Central Lancashire, Preston, UK
| | - F D Richard Hobbs
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Una Martin
- Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Claire Schwartz
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - David McCartney
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Rachel O’Mahony
- Centre for Guidelines, National Institute for Health and Care Excellence, London, UK
| | - Rafael Perera-Salazar
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Nia Roberts
- Bodleian Health Care Libraries, Knowledge Centre, Oxford, UK
| | - Sarah Stevens
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Bryan Williams
- NIHR UCL Hospitals Biomedical Research Centre, Institute of Cardiovascular Science, University College London, London, UK
| | - Richard J McManus
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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16
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Satoh M, Murakami T, Asayama K, Hirose T, Kikuya M, Inoue R, Tsubota-Utsugi M, Murakami K, Matsuda A, Hara A, Obara T, Kawasaki R, Nomura K, Metoki H, Node K, Imai Y, Ohkubo T. N-Terminal Pro-B-Type Natriuretic Peptide Is Not a Significant Predictor of Stroke Incidence After 5 Years - The Ohasama Study. Circ J 2018; 82:2055-2062. [PMID: 29887544 DOI: 10.1253/circj.cj-17-1227] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND N-terminal pro-B-type natriuretic peptide (NT-proBNP) has been used for risk stratification in heart failure or acute coronary syndrome, but the beyond 5-year predictive value of NT-proBNP for stroke remains an unsettled issue in Asian patients. The aim of the present study was to clarify this point.Methods and Results:We followed 1,198 participants (33.4% men; mean age, 60.5±11.1 years old) in the Japanese general population for a median of 13.0 years. A first stroke occurred in 93 participants. Referencing previous reports, we stratified participants according to NT-proBNP 30.0, 55.0, and 125.0 pg/mL. Using the NT-proBNP <30.0 pg/mL group as a reference, adjusted HR for stroke (95% CI) in the NT-proBNP 30.0-54.9-pg/mL, 55.0-124.9-pg/mL, and ≥125.0-pg/mL groups were 1.92 (0.94-3.94), 1.77 (0.85-3.66), and 1.99 (0.86-4.61), respectively. With the maximum follow-up period set at 5 years, the hazard ratio of the NT-proBNP≥125.0-pg/mL group compared with the <30.0-pg/mL group increased significantly (HR, 4.51; 95% CI: 1.03-19.85). On extension of the maximum follow-up period, however, the association between NT-proBNP and stroke risk weakened. CONCLUSIONS NT-proBNP was significantly associated with an elevated stroke risk. Given, however, that the predictive power decreased with the number of years after NT-proBNP measurement, NT-proBNP should be re-evaluated periodically in Asian patients.
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Affiliation(s)
- Michihiro Satoh
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University
| | - Takahisa Murakami
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University.,Division of Aging and Geriatric Dentistry, Department of Oral Function and Morphology, Tohoku University Graduate School of Dentistry
| | - Kei Asayama
- Department of Hygiene and Public Health, Teikyo University School of Medicine.,Tohoku Institute for Management of Blood Pressure
| | - Takuo Hirose
- Division of Nephrology and Endocrinology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University
| | - Masahiro Kikuya
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University
| | - Ryusuke Inoue
- Department of Medical Information Technology Center, Tohoku University Hospital
| | - Megumi Tsubota-Utsugi
- Department of Hygiene and Preventive Medicine, Iwate Medical University School of Medicine
| | - Keiko Murakami
- Department of Hygiene and Public Health, Teikyo University School of Medicine
| | - Ayako Matsuda
- Department of Hygiene and Public Health, Teikyo University School of Medicine
| | - Azusa Hara
- Department of Social Pharmacy and Public Health, Showa Pharmaceutical University
| | - Taku Obara
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University.,Department of Pharmaceutical Sciences, Tohoku University Hospital
| | - Ryo Kawasaki
- Department of Vision Informatics (Topcon), Osaka University Graduate School of Medicine.,Department of Public Health, Yamagata University Graduate School of Medical Science
| | - Kyoko Nomura
- Department of Public Health, Akita University Graduate School of Medicine
| | - Hirohito Metoki
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University.,Tohoku Institute for Management of Blood Pressure.,Department of Community Medical Supports, Tohoku Medical Megabank Organization, Tohoku University
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
| | - Yutaka Imai
- Tohoku Institute for Management of Blood Pressure
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine.,Tohoku Institute for Management of Blood Pressure
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17
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Home blood pressure predicts stroke incidence among older adults with impaired physical function: the Ohasama study. J Hypertens 2017; 35:2395-2401. [PMID: 28697009 DOI: 10.1097/hjh.0000000000001473] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Several observational studies have found modifying effects of functional status on the association between conventional office blood pressure (BP) and adverse outcomes. We aimed to examine whether the association between higher BP and stroke was attenuated or inverted among older adults with impaired function using self-measured home BP measurements. METHODS We followed 501 Japanese community-dwelling adults aged at least 60 years (mean age, 68.6 years) with no history of stroke. Multivariate-adjusted hazard ratios for 1-SD increase in home BP and office BP measurements were calculated by the Cox proportional hazards model. Functional status was assessed by self-reported physical function. RESULTS During a median follow-up of 11.5 years, first strokes were observed in 47 participants. Higher home SBP, but not office SBP, was significantly associated with increased risk of stroke among both 349 participants with normal physical function and 152 participants with impaired physical function [hazard ratio (95% confidence interval) per 14.4-mmHg increase: 1.74 (1.12-2.69) and 1.77 (1.06-2.94), respectively], with no significant interaction for physical function (P = 0.56). Higher home DBP, but not office DBP, was also significantly associated with increased risk of stroke (P ≤ 0.029) irrespective of physical function (all P > 0.05 for interaction). Neither home BP nor office BP was significantly associated with all-cause mortality irrespective of physical function. CONCLUSION Higher home BP was associated with increased risk of stroke even among those with impaired physical function. Measurements of home BP would be useful for stroke prevention, even after physical function decline.
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18
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Fujiwara T, Hoshide S, Nishizawa M, Matsuo T, Kario K. Difference in evening home blood pressure between before dinner and at bedtime in Japanese elderly hypertensive patients. J Clin Hypertens (Greenwich) 2017; 19:731-739. [PMID: 28294513 PMCID: PMC8031294 DOI: 10.1111/jch.12985] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 12/28/2016] [Accepted: 12/30/2016] [Indexed: 08/01/2023]
Abstract
The authors evaluated the differences between evening home blood pressure (HBP) readings taken before dinner and those taken at bedtime, which were documented in a European and a Japanese guideline, respectively. Forty-eight patients (mean age, 76.4 years) measured their evening HBP twice each day (two measurements both before dinner and at bedtime) for 14 days. The authors defined the at-bedtime (B) minus the before-dinner (D) systolic HBP as the B-D difference. The mean B-D difference was -8.7 mm Hg (P<.001). The depressor effect of bathing was significantly prolonged for 120 minutes. The B-D difference with alcohol consumption was significantly greater than that without alcohol. In the linear mixed model analysis, time after bathing ≤120 minutes and alcohol consumption were significantly associated with the B-D difference after adjustment with covariates. There was a marked difference between evening HBP values. When patients' evening HBP is measured according to the guidelines, their daily activities should be considered.
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Affiliation(s)
- Takeshi Fujiwara
- Jichi Medical University School of MedicineShimotsukeJapan
- Higashiagatsuma‐machi National Health Insurance ClinicGunmaJapan
| | | | - Masafumi Nishizawa
- Jichi Medical University School of MedicineShimotsukeJapan
- Minamisanriku Public Medical ClinicMiyagiJapan
| | - Takefumi Matsuo
- Jichi Medical University School of MedicineShimotsukeJapan
- Hyogo Prefectural Awagi Medical CenterSumotoJapan
| | - Kazuomi Kario
- Jichi Medical University School of MedicineShimotsukeJapan
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19
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Sakata S, Hata J, Fukuhara M, Yonemoto K, Mukai N, Yoshida D, Kishimoto H, Ohtsubo T, Kitazono T, Kiyohara Y, Ninomiya T. Morning and Evening Blood Pressures Are Associated With Intima-Media Thickness in a General Population - The Hisayama Study. Circ J 2017. [PMID: 28626161 DOI: 10.1253/circj.cj-16-1306] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The association of morning and evening home blood pressures (HBPs) with carotid atherosclerosis has been uncertain in general populations, so we aimed to investigate it in a general Japanese population.Methods and Results:We performed a cross-sectional survey of 2,856 community-dwelling individuals aged ≥40 years to examine the association of morning and evening HBPs with carotid mean intima-media thickness (IMT). The age- and sex-adjusted geometric averages of carotid mean IMT increased significantly with increasing morning HBP (optimal: 0.67 mm; normal: 0.69 mm; high normal: 0.72 mm; grade 1 hypertension: 0.74 mm; and grade 2+3 hypertension: 0.76 mm) and with increasing evening HBP (0.68 mm, 0.71 mm, 0.73 mm, 0.76 mm, and 0.78 mm, respectively) (both P for trend <0.001). These associations remained significant even after adjusting for potential confounding factors. Likewise, both isolated morning hypertension (morning HBP ≥135/85 mmHg and evening HBP <135/85 mmHg) and isolated evening hypertension (evening HBP ≥135/85 mmHg and morning HBP <135/85 mmHg) as well as sustained hypertension (both morning and evening HBP ≥135/85 mmHg) were significantly associated with thicker mean IMT. CONCLUSIONS Our findings suggested that both morning and evening HBPs were significantly associated with carotid atherosclerosis in this general Japanese population.
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Affiliation(s)
- Satoko Sakata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
| | - Masayo Fukuhara
- Division of General Internal Medicine, Kyushu Dental University
| | - Koji Yonemoto
- Advanced Medical Research Center, Faculty of Medicine, University of the Ryukyus
| | - Naoko Mukai
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
| | - Daigo Yoshida
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University
| | - Hiro Kishimoto
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University
| | - Toshio Ohtsubo
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
| | - Takanari Kitazono
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
| | | | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University
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20
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Juhanoja EP, Niiranen TJ, Johansson JK, Puukka PJ, Thijs L, Asayama K, Langén VL, Hozawa A, Aparicio LS, Ohkubo T, Tsuji I, Imai Y, Stergiou GS, Jula AM, Staessen JA. Outcome-Driven Thresholds for Increased Home Blood Pressure Variability. Hypertension 2017; 69:599-607. [PMID: 28193705 DOI: 10.1161/hypertensionaha.116.08603] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 11/26/2016] [Accepted: 11/29/2016] [Indexed: 11/16/2022]
Abstract
Increased blood pressure (BP) variability predicts cardiovascular disease, but lack of operational thresholds limits its use in clinical practice. Our aim was to define outcome-driven thresholds for increased day-to-day home BP variability. We studied a population-based sample of 6238 individuals (mean age 60.0±12.9, 56.4% women) from Japan, Greece, and Finland. All participants self-measured their home BP on ≥3 days. We defined home BP variability as the coefficient of variation of the first morning BPs on 3 to 7 days. We assessed the association between systolic/diastolic BP variability (as a continuous variable and in deciles of coefficient of variation) and cardiovascular outcomes using Cox regression models adjusted for cohort and classical cardiovascular risk factors, including BP. During a follow-up of 9.3±3.6 years, 304 cardiovascular deaths and 715 cardiovascular events occurred. A 1 SD increase in systolic/diastolic home BP variability was associated with increased risk of cardiovascular mortality (hazard ratio, 1.17/1.22; 95% confidence interval, 1.06-1.30/1.11-1.34; P=0.003/<0.0001) and cardiovascular events (hazard ratio, 1.13/1.14; 95% confidence interval, 1.05-1.21/1.07-1.23; P=0.0007/0.0002). Compared with the average risk in the whole population, risk of cardiovascular deaths (hazard ratio, 1.66/1.84; 95% confidence interval, 1.27-2.17/1.42-2.37; P=0.0002/<0.0001) and events (hazard ratio, 1.46/1.42; 95% confidence interval, 1.21-1.76/1.17-1.71; P<0.0001/0.0004) was increased in the highest decile of systolic/diastolic BP variability (coefficient of variation>11.0/12.8). Increased home BP variability predicts cardiovascular outcomes in the general population. Individuals with a systolic/diastolic coefficient of variation of day-to-day home BP >11.0/12.8 may have an increased risk of cardiovascular disease. These findings could help physicians identify individuals who are at an increased cardiovascular disease risk.
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Affiliation(s)
- Eeva P Juhanoja
- From the Department of Health, National Institute for Health and Welfare, Turku, Finland (E.P.J., T.J.N., J.K.J., P.J.P., V.L.L., A.M.J.); Division of Medicine (E.P.J.) and Heart Centre (V.L.L.), Turku University Hospital, Finland; Department of Medicine, University of Turku, Finland (E.P.J., A.M.J.); Framingham Heart Study, Boston University, MA (T.J.N.); Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.T., J.A.S.); Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan (K.A., T.O., Y.I.); Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan (A.H.); Hospital Italiano de Buenos Aires, Argentina (L.S.A.); Department of Public Health, Tohoku University Graduate School of Medicine, Sendai, Japan (I.T.); Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Greece (G.S.S.); and R&D VitaK Group, Maastricht University, The Netherlands (J.A.S.).
| | - Teemu J Niiranen
- From the Department of Health, National Institute for Health and Welfare, Turku, Finland (E.P.J., T.J.N., J.K.J., P.J.P., V.L.L., A.M.J.); Division of Medicine (E.P.J.) and Heart Centre (V.L.L.), Turku University Hospital, Finland; Department of Medicine, University of Turku, Finland (E.P.J., A.M.J.); Framingham Heart Study, Boston University, MA (T.J.N.); Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.T., J.A.S.); Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan (K.A., T.O., Y.I.); Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan (A.H.); Hospital Italiano de Buenos Aires, Argentina (L.S.A.); Department of Public Health, Tohoku University Graduate School of Medicine, Sendai, Japan (I.T.); Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Greece (G.S.S.); and R&D VitaK Group, Maastricht University, The Netherlands (J.A.S.)
| | - Jouni K Johansson
- From the Department of Health, National Institute for Health and Welfare, Turku, Finland (E.P.J., T.J.N., J.K.J., P.J.P., V.L.L., A.M.J.); Division of Medicine (E.P.J.) and Heart Centre (V.L.L.), Turku University Hospital, Finland; Department of Medicine, University of Turku, Finland (E.P.J., A.M.J.); Framingham Heart Study, Boston University, MA (T.J.N.); Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.T., J.A.S.); Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan (K.A., T.O., Y.I.); Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan (A.H.); Hospital Italiano de Buenos Aires, Argentina (L.S.A.); Department of Public Health, Tohoku University Graduate School of Medicine, Sendai, Japan (I.T.); Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Greece (G.S.S.); and R&D VitaK Group, Maastricht University, The Netherlands (J.A.S.)
| | - Pauli J Puukka
- From the Department of Health, National Institute for Health and Welfare, Turku, Finland (E.P.J., T.J.N., J.K.J., P.J.P., V.L.L., A.M.J.); Division of Medicine (E.P.J.) and Heart Centre (V.L.L.), Turku University Hospital, Finland; Department of Medicine, University of Turku, Finland (E.P.J., A.M.J.); Framingham Heart Study, Boston University, MA (T.J.N.); Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.T., J.A.S.); Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan (K.A., T.O., Y.I.); Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan (A.H.); Hospital Italiano de Buenos Aires, Argentina (L.S.A.); Department of Public Health, Tohoku University Graduate School of Medicine, Sendai, Japan (I.T.); Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Greece (G.S.S.); and R&D VitaK Group, Maastricht University, The Netherlands (J.A.S.)
| | - Lutgarde Thijs
- From the Department of Health, National Institute for Health and Welfare, Turku, Finland (E.P.J., T.J.N., J.K.J., P.J.P., V.L.L., A.M.J.); Division of Medicine (E.P.J.) and Heart Centre (V.L.L.), Turku University Hospital, Finland; Department of Medicine, University of Turku, Finland (E.P.J., A.M.J.); Framingham Heart Study, Boston University, MA (T.J.N.); Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.T., J.A.S.); Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan (K.A., T.O., Y.I.); Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan (A.H.); Hospital Italiano de Buenos Aires, Argentina (L.S.A.); Department of Public Health, Tohoku University Graduate School of Medicine, Sendai, Japan (I.T.); Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Greece (G.S.S.); and R&D VitaK Group, Maastricht University, The Netherlands (J.A.S.)
| | - Kei Asayama
- From the Department of Health, National Institute for Health and Welfare, Turku, Finland (E.P.J., T.J.N., J.K.J., P.J.P., V.L.L., A.M.J.); Division of Medicine (E.P.J.) and Heart Centre (V.L.L.), Turku University Hospital, Finland; Department of Medicine, University of Turku, Finland (E.P.J., A.M.J.); Framingham Heart Study, Boston University, MA (T.J.N.); Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.T., J.A.S.); Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan (K.A., T.O., Y.I.); Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan (A.H.); Hospital Italiano de Buenos Aires, Argentina (L.S.A.); Department of Public Health, Tohoku University Graduate School of Medicine, Sendai, Japan (I.T.); Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Greece (G.S.S.); and R&D VitaK Group, Maastricht University, The Netherlands (J.A.S.)
| | - Ville L Langén
- From the Department of Health, National Institute for Health and Welfare, Turku, Finland (E.P.J., T.J.N., J.K.J., P.J.P., V.L.L., A.M.J.); Division of Medicine (E.P.J.) and Heart Centre (V.L.L.), Turku University Hospital, Finland; Department of Medicine, University of Turku, Finland (E.P.J., A.M.J.); Framingham Heart Study, Boston University, MA (T.J.N.); Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.T., J.A.S.); Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan (K.A., T.O., Y.I.); Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan (A.H.); Hospital Italiano de Buenos Aires, Argentina (L.S.A.); Department of Public Health, Tohoku University Graduate School of Medicine, Sendai, Japan (I.T.); Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Greece (G.S.S.); and R&D VitaK Group, Maastricht University, The Netherlands (J.A.S.)
| | - Atsushi Hozawa
- From the Department of Health, National Institute for Health and Welfare, Turku, Finland (E.P.J., T.J.N., J.K.J., P.J.P., V.L.L., A.M.J.); Division of Medicine (E.P.J.) and Heart Centre (V.L.L.), Turku University Hospital, Finland; Department of Medicine, University of Turku, Finland (E.P.J., A.M.J.); Framingham Heart Study, Boston University, MA (T.J.N.); Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.T., J.A.S.); Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan (K.A., T.O., Y.I.); Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan (A.H.); Hospital Italiano de Buenos Aires, Argentina (L.S.A.); Department of Public Health, Tohoku University Graduate School of Medicine, Sendai, Japan (I.T.); Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Greece (G.S.S.); and R&D VitaK Group, Maastricht University, The Netherlands (J.A.S.)
| | - Lucas S Aparicio
- From the Department of Health, National Institute for Health and Welfare, Turku, Finland (E.P.J., T.J.N., J.K.J., P.J.P., V.L.L., A.M.J.); Division of Medicine (E.P.J.) and Heart Centre (V.L.L.), Turku University Hospital, Finland; Department of Medicine, University of Turku, Finland (E.P.J., A.M.J.); Framingham Heart Study, Boston University, MA (T.J.N.); Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.T., J.A.S.); Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan (K.A., T.O., Y.I.); Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan (A.H.); Hospital Italiano de Buenos Aires, Argentina (L.S.A.); Department of Public Health, Tohoku University Graduate School of Medicine, Sendai, Japan (I.T.); Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Greece (G.S.S.); and R&D VitaK Group, Maastricht University, The Netherlands (J.A.S.)
| | - Takayoshi Ohkubo
- From the Department of Health, National Institute for Health and Welfare, Turku, Finland (E.P.J., T.J.N., J.K.J., P.J.P., V.L.L., A.M.J.); Division of Medicine (E.P.J.) and Heart Centre (V.L.L.), Turku University Hospital, Finland; Department of Medicine, University of Turku, Finland (E.P.J., A.M.J.); Framingham Heart Study, Boston University, MA (T.J.N.); Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.T., J.A.S.); Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan (K.A., T.O., Y.I.); Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan (A.H.); Hospital Italiano de Buenos Aires, Argentina (L.S.A.); Department of Public Health, Tohoku University Graduate School of Medicine, Sendai, Japan (I.T.); Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Greece (G.S.S.); and R&D VitaK Group, Maastricht University, The Netherlands (J.A.S.)
| | - Ichiro Tsuji
- From the Department of Health, National Institute for Health and Welfare, Turku, Finland (E.P.J., T.J.N., J.K.J., P.J.P., V.L.L., A.M.J.); Division of Medicine (E.P.J.) and Heart Centre (V.L.L.), Turku University Hospital, Finland; Department of Medicine, University of Turku, Finland (E.P.J., A.M.J.); Framingham Heart Study, Boston University, MA (T.J.N.); Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.T., J.A.S.); Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan (K.A., T.O., Y.I.); Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan (A.H.); Hospital Italiano de Buenos Aires, Argentina (L.S.A.); Department of Public Health, Tohoku University Graduate School of Medicine, Sendai, Japan (I.T.); Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Greece (G.S.S.); and R&D VitaK Group, Maastricht University, The Netherlands (J.A.S.)
| | - Yutaka Imai
- From the Department of Health, National Institute for Health and Welfare, Turku, Finland (E.P.J., T.J.N., J.K.J., P.J.P., V.L.L., A.M.J.); Division of Medicine (E.P.J.) and Heart Centre (V.L.L.), Turku University Hospital, Finland; Department of Medicine, University of Turku, Finland (E.P.J., A.M.J.); Framingham Heart Study, Boston University, MA (T.J.N.); Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.T., J.A.S.); Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan (K.A., T.O., Y.I.); Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan (A.H.); Hospital Italiano de Buenos Aires, Argentina (L.S.A.); Department of Public Health, Tohoku University Graduate School of Medicine, Sendai, Japan (I.T.); Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Greece (G.S.S.); and R&D VitaK Group, Maastricht University, The Netherlands (J.A.S.)
| | - George S Stergiou
- From the Department of Health, National Institute for Health and Welfare, Turku, Finland (E.P.J., T.J.N., J.K.J., P.J.P., V.L.L., A.M.J.); Division of Medicine (E.P.J.) and Heart Centre (V.L.L.), Turku University Hospital, Finland; Department of Medicine, University of Turku, Finland (E.P.J., A.M.J.); Framingham Heart Study, Boston University, MA (T.J.N.); Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.T., J.A.S.); Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan (K.A., T.O., Y.I.); Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan (A.H.); Hospital Italiano de Buenos Aires, Argentina (L.S.A.); Department of Public Health, Tohoku University Graduate School of Medicine, Sendai, Japan (I.T.); Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Greece (G.S.S.); and R&D VitaK Group, Maastricht University, The Netherlands (J.A.S.)
| | - Antti M Jula
- From the Department of Health, National Institute for Health and Welfare, Turku, Finland (E.P.J., T.J.N., J.K.J., P.J.P., V.L.L., A.M.J.); Division of Medicine (E.P.J.) and Heart Centre (V.L.L.), Turku University Hospital, Finland; Department of Medicine, University of Turku, Finland (E.P.J., A.M.J.); Framingham Heart Study, Boston University, MA (T.J.N.); Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.T., J.A.S.); Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan (K.A., T.O., Y.I.); Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan (A.H.); Hospital Italiano de Buenos Aires, Argentina (L.S.A.); Department of Public Health, Tohoku University Graduate School of Medicine, Sendai, Japan (I.T.); Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Greece (G.S.S.); and R&D VitaK Group, Maastricht University, The Netherlands (J.A.S.)
| | - Jan A Staessen
- From the Department of Health, National Institute for Health and Welfare, Turku, Finland (E.P.J., T.J.N., J.K.J., P.J.P., V.L.L., A.M.J.); Division of Medicine (E.P.J.) and Heart Centre (V.L.L.), Turku University Hospital, Finland; Department of Medicine, University of Turku, Finland (E.P.J., A.M.J.); Framingham Heart Study, Boston University, MA (T.J.N.); Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (L.T., J.A.S.); Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan (K.A., T.O., Y.I.); Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan (K.A., T.O.); Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan (A.H.); Hospital Italiano de Buenos Aires, Argentina (L.S.A.); Department of Public Health, Tohoku University Graduate School of Medicine, Sendai, Japan (I.T.); Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Greece (G.S.S.); and R&D VitaK Group, Maastricht University, The Netherlands (J.A.S.)
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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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Parati G, Ochoa JE, Lombardi C, Bilo G. Blood pressure variability: assessment, predictive value, and potential as a therapeutic target. Curr Hypertens Rep 2016; 17:537. [PMID: 25790801 DOI: 10.1007/s11906-015-0537-1] [Citation(s) in RCA: 145] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
A large body of evidence has consistently supported the relationship between blood pressure (BP) levels and the risk of cardiovascular complications. In recent years, several independent studies have also indicated that this risk may not only depend on the magnitude of the blood pressure elevation per se but also on the presence of other associated conditions such as increased blood pressure variability. This concept has been supported by a series of reports, most of which post hoc analyses of clinical trials in hypertension, showing that increasing values of BP variability (BPV) (either in the short term, in the midterm, or in the long term) may predict development, progression, and severity of cardiac, vascular, and renal organ damage, as well as cardiovascular events and mortality. Remarkably, studies conducted in populations at high cardiovascular risk have shown increasing values of BPV in the individual subjects (so-called intra- or within-individual BPV) to be strong predictors of cardiovascular morbidity and mortality, even to a larger extent than average BP values. However, in subjects at low to moderate cardiovascular risk, the contribution of BPV to cardiovascular risk prediction over and beyond average BP values has been shown to be only moderate. The aim of this paper is to critically review the evidence addressing the prognostic relevance of different components of BPV addressing a yet open question, i.e., whether routine assessment of BPV in clinical practice should be regarded as an additional target of antihypertensive treatment to improve cardiovascular protection.
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Affiliation(s)
- Gianfranco Parati
- Department of Health Sciences, University of Milan-Bicocca, Milan, Italy,
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Ryu J, Cha RH, Kim DK, Lee JH, Yoon SA, Ryu DR, Oh J, Kim S, Han SY, Lee EY, Kim YS. Time points for obtaining representative values of 24-hour blood pressure in chronic kidney disease. Korean J Intern Med 2015; 30:665-74. [PMID: 26354061 PMCID: PMC4578022 DOI: 10.3904/kjim.2015.30.5.665] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2014] [Revised: 07/10/2014] [Accepted: 07/31/2014] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS Ambulatory blood pressure (BP) monitoring has been widely recommended for evaluating the status of BP, but is lacking in practicality. Determination of the specific time points for BP measurement that are representative of 24-hour mean BP could be useful and convenient in hypertensive patients with chronic kidney disease (CKD). METHODS A total of 1,317 patients for whom 24-hour ambulatory BP monitoring was performed were enrolled in a multicenter study on hypertensive CKD. We analyzed the time points at which systolic blood pressure (SBP) values exhibited the smallest differences from 24-hour mean SBP (mSBP). We included office mSBP and analyzed the relationships between SBPs at the office and the time points with the smallest differences from 24-hour mSBP using several methods. RESULTS The time points with the smallest differences from 24-hour mSBP were 7:00 AM, 2:00 PM, and 9:30 PM. In regression analysis, SBPs at 7:00 AM and 9:30 PM were better correlated with 24-hour mSBP than SBPs at 2:00 PM and the office. The proportions of patients with SBPs within 30% of 24-hour mSBP were higher at 7:00 AM and 9:30 PM. The best consistency between the uncontrolled hypertensive groups, defined as ≥ 135 mmHg of 24-hour mSBP and higher values of SBPs corresponding to 135 mmHg of 24-hour mSBP, were observed at the 7:00 AM and 9:30 PM time points. CONCLUSIONS The specific time points for SBPs that correlated well with 24-hour mSBP in hypertensive CKD patients were 7:00 AM and 9:30 PM.
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Affiliation(s)
- Jiwon Ryu
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Ran-hui Cha
- Department of Internal Medicine, National Medical Center, Seoul, Korea
| | - Dong Ki Kim
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Ju Hyun Lee
- Medical Research Collaborating Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sun Ae Yoon
- Department of Internal Medicine, College of Medicine, Uijeongbu St. Mary’s Hospital, The Catholic University of Korea, Uijeongbu, Korea
| | - Dong Ryeol Ryu
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Jieun Oh
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Sejoong Kim
- Medical Research Collaborating Center, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
- Correspondence to Sejoong Kim, M.D. Department of Internal Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea Tel: +82-31-787-7051 Fax: +82-31-787-4052 E-mail:
| | - Sang-Youb Han
- Department of Internal Medicine, Inje University College of Medicine, Goyang, Korea
| | - Eun Young Lee
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Yon Su Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
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Okada T, Wada T, Nagaoka Y, Kanno Y. Association between visit-to-visit clinic blood pressure variability and home blood pressure variability in patients with chronic kidney disease. Ren Fail 2015; 37:446-51. [DOI: 10.3109/0886022x.2014.996730] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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Determinants of the Morning-Evening Home Blood Pressure Difference in Treated Hypertensives: The HIBA-Home Study. Int J Hypertens 2014; 2014:569259. [PMID: 25580283 PMCID: PMC4279721 DOI: 10.1155/2014/569259] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 11/26/2014] [Accepted: 11/26/2014] [Indexed: 12/23/2022] Open
Abstract
Background. The morning home blood pressure (BP) rise is a significant asymptomatic target organ damage predictor in hypertensives. Our aim was to evaluate determinants of home-based morning-evening difference (MEdiff) in Argentine patients. Methods. Treated hypertensive patients aged ≥18 years participated in a cross-sectional study, after performing home morning and evening BP measurement. MEdiff was morning minus evening home average results. Variables identified as relevant predictors were entered into a multivariable linear regression analysis model. Results. Three hundred sixty-seven medicated hypertensives were included. Mean age was 66.2 (14.5), BMI 28.1 (4.5), total cholesterol 4.89 (1.0) mmol/L, 65.9% women, 11.7% smokers, and 10.6% diabetics. Mean MEdiff was 1.1 (12.5) mmHg systolic and 2.3 (6.1) mmHg diastolic, respectively. Mean self-recorded BP was 131.5 (14.1) mmHg systolic and 73.8 (7.6) mmHg diastolic, respectively. Mean morning and evening home BPs were 133.1 (16.5) versus 132 (15.7) systolic and 75.8 (8.4) versus 73.5 (8.2) diastolic, respectively. Significant beta-coefficient values were found in systolic MEdiff for age and smoking and in diastolic MEdiff for age, smoking, total cholesterol, and calcium-channel blockers. Conclusions. In a cohort of Argentine medicated patients, older age, smoking, total cholesterol, and use of calcium channel blockers were independent determinants of home-based MEdiff.
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Imai Y, Hosaka M, Elnagar N, Satoh M. Clinical significance of home blood pressure measurements for the prevention and management of high blood pressure. Clin Exp Pharmacol Physiol 2014; 41:37-45. [PMID: 23763494 DOI: 10.1111/1440-1681.12142] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Revised: 05/20/2013] [Accepted: 06/07/2013] [Indexed: 12/12/2022]
Abstract
1. Ambulatory blood pressure (ABP) monitoring (M) provides BP information at many points on any particular day during unrestricted routine daily activities, whereas home blood pressure (HBP) monitoring provides a lot of BP information obtained under fixed times and conditions over a long period of time, thus mean values of HBP provide high reproducibility, and thus an overall superiority compared with ABP. 2. HBP is at least equally or better able than ABP to predict hypertensive target organ damage and prognosis of cardiovascular disease. 3. HBPM allows for ongoing disease monitoring by patients, improves adherence to antihypertensive treatment, and can provide health-care providers with timely clinical data and direct and immediate feedback regarding diagnosis and treatment of hypertension. 4. HBPM provides BP information in relation to time; that is, BP in the morning, in the evening and at night during sleep, and it is an essential tool for the diagnosis of white-coat and masked hypertension. 5. HBPM yields minimal alerting affects and no or minimal placebo effect, and can therefore distinguish small, but significant, serial changes in BP. It is thus the most practical method for monitoring BP in the day-to-day management of hypertension. 6. The superiority of HBPM over ABPM and clinic BPM is apparent from almost all practical and clinical research perspectives.
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Affiliation(s)
- Yutaka Imai
- Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan
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Satoh M, Hosaka M, Asayama K, Kikuya M, Inoue R, Metoki H, Utsugi MT, Hara A, Hirose T, Obara T, Mori T, Totsune K, Hoshi H, Mano N, Imai Y, Ohkubo T. Aldosterone-to-renin ratio and nocturnal blood pressure decline assessed by self-measurement of blood pressure at home: the Ohasama Study. Clin Exp Hypertens 2014; 36:108-14. [DOI: 10.3109/10641963.2014.892121] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Blood pressure variability assessed by home measurements: a systematic review. Hypertens Res 2014; 37:565-72. [PMID: 24553366 DOI: 10.1038/hr.2014.2] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2013] [Revised: 11/22/2013] [Accepted: 11/27/2013] [Indexed: 11/08/2022]
Abstract
Accumulating evidence suggests that day-by-day blood pressure (BP) variability assessed using self-measurements by patients at home (HBPV) provides useful information beyond that of average home BP. This systematic review summarizes the current evidence on day-by-day HBPV. A systematic literature search (PubMed) revealed 22 eligible articles. Independent prognostic value of day-by-day HBPV for cardiovascular events and total mortality was demonstrated in two outcome studies, whereas novel indices of variability had minimal or no independent prognostic ability. Although findings are not consistent among the studies, the evidence suggests that HBPV has an independent role in the progression of preclinical cardiac, arterial and renal damage and is affected by age, gender, average BP and heart rate level, antihypertensive treatment, antihypertensive drug class and other factors. However, there is large diversity among the available studies in the home BP monitoring protocols, the indices used to quantify HBPV and the end points selected for evaluation. Overall, these preliminary data largely based on heterogeneous studies indicate an important and independent role of day-by-day HBPV in the pathogenesis of hypertension-induced cardiovascular damage. Yet, fundamental questions remain unanswered, including the optimal variability index, the optimal home monitoring schedule required, the threshold that defines increased HBPV and the impact of treatment-induced variability change on organ damage and cardiovascular events. Until these questions are adequately addressed in future studies, HBPV should largely remain a research issue with limited practical value for individual patients.
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Imai Y. Clinical significance of home blood pressure and its possible practical application. Clin Exp Nephrol 2013; 18:24-40. [DOI: 10.1007/s10157-013-0831-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Accepted: 06/14/2013] [Indexed: 10/26/2022]
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Imai Y, Kario K, Shimada K, Kawano Y, Hasebe N, Matsuura H, Tsuchihashi T, Ohkubo T, Kuwajima I, Miyakawa M. The Japanese Society of Hypertension Guidelines for Self-monitoring of Blood Pressure at Home (Second Edition). Hypertens Res 2012; 35:777-95. [PMID: 22863910 DOI: 10.1038/hr.2012.56] [Citation(s) in RCA: 142] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Yutaka Imai
- Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmacological Sciences, Sendai, Japan
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Elliott MR, Soto Soto JM, Haley WE, Fitzpatrick PM, Dwyer JP. Labile Hypertension: Characteristics of a Referred Cohort. Clin Exp Hypertens 2012; 35:207-12. [DOI: 10.3109/10641963.2012.712180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Home blood pressure level, blood pressure variability, smoking, and stroke risk in Japanese men: the Ohasama study. Am J Hypertens 2012; 25:883-91. [PMID: 22673020 DOI: 10.1038/ajh.2012.62] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Hypertension and smoking independently contribute to the risk of stroke. Our objective was to investigate home blood pressure (HBP) levels, day-by-day BP variability, and smoking in the prediction of stroke in Japanese men. METHODS In this study, 902 men (mean age, 58.6 years) without a past history of stroke were evaluated. HBP was measured once every morning for 4 weeks. Day-by-day BP variability was defined as within-subject standard deviations (SD) of HBP. Smoking history was obtained from a standardized questionnaire. Hazard ratios (HRs) for stroke were examined by Cox regression model, with adjustment for possible confounders. RESULTS During 13.1 years (median) of follow-up, 89 cerebral infarctions, 28 intracranial hemorrhages, and six other strokes occurred. Systolic HBP levels (HR = 1.59 per 14.6 mm Hg increase, P < 0.0001) and variability (HR = 1.26 per 3.1 mm Hg increase, P = 0.03) of +1 between-subject SD were significantly associated with cerebral infarction. The relationship between HBP and cerebral infarction differed with smoking status (interaction P = 0.021 and 0.017 for systolic level and variability, respectively). In analyses stratified according to smoking, systolic level (HR = 1.78, P < 0.0001) and variability (HR = 1.38, P = 0.006) were significantly associated with cerebral infarction in ever smokers (N = 511), but not in never smokers (N = 391; P ≥ 0.6 for both). No significant association was found between smoking and the risk of intracranial hemorrhage. CONCLUSIONS In ever smokers, both HBP levels and variability are significantly associated with the risk of cerebral infarction. Our findings further validate the benefit of smoking cessation in preventing cardiovascular disease (CVD), especially cerebral infarction.
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Blasche GW, Weissensteiner K, Marktl W. Travel-related change of residence leads to a transitory stress reaction in humans. J Travel Med 2012; 19:243-9. [PMID: 22776386 DOI: 10.1111/j.1708-8305.2012.00624.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE It is well known that animals show a stress response when confronted with a novel environment. The aim of the this study was to investigate whether humans show a similar response by studying the reaction to a travel-related transitory change of residence. METHOD Forty-eight individuals (32 women, 16 men, age 40-83 years) traveling to a health resort approximately 120 km from their home town participated in the study. Individuals monitored their blood pressure (BP) twice a day 3 weeks before (baseline) and during the stay and filled out a diary stating their mood and sleep. The change of the variables relative to baseline on the day before departure, the travel day, and the day after arrival as well as 5 days after arrival were determined. RESULTS Systolic and diastolic BPs were increased on the day before travel and diastolic BP remained increased on the travel day and the day after arrival. Sleep was poorer during the first night at the new residence. All three variables had returned to baseline level 5 days into the stay. Mood was not affected by the change of residence. CONCLUSION The results indicate that not only the change of residence but also its anticipation affects individuals in a transient way. The findings are relevant not only for the basic understanding of the reaction to novel environments but also to travel, tourism as well as rehabilitation, and spa-research.
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Affiliation(s)
- Gerhard W Blasche
- Department of Environmental Hygiene, Centre for Public Health of the Medical University of Vienna, Kinderspitalgasse 15, Vienna, Austria.
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Gonokami K, Kikuya M, Ohkubo T, Satoh M, Hashimoto T, Hirose T, Obara T, Metoki H, Inoue R, Asayama K, Kanno A, Totsune K, Hoshi H, Satoh H, Imai Y. Associated Factors of Home Versus Ambulatory Heart Rate Variability in the General Population: The Ohasama Study. Clin Exp Hypertens 2011; 33:404-10. [DOI: 10.3109/10641963.2010.549269] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Niiranen TJ, Johansson JK, Reunanen A, Jula AM. Optimal schedule for home blood pressure measurement based on prognostic data: the Finn-Home Study. Hypertension 2011; 57:1081-6. [PMID: 21482956 DOI: 10.1161/hypertensionaha.110.162123] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Current guidelines based on cross-sectional statistical parameters derived from reference populations make equivocal recommendations for the optimal schedule of home blood pressure (BP) measurement. The objective of this study was to determine a schedule for home BP measurements in relation to their predictive value for total cardiovascular risk. Home BP was measured twice every morning and evening for 1 week in an unselected nationwide population of 2081 subjects aged 45 to 74 years. The prognostic significance of BP for fatal and nonfatal cardiovascular events was examined using adjusted Cox proportional hazards regression models. A total of 162 cardiovascular events were recorded during a 6.8-year follow-up. The predictive value of home BP increased progressively with the number of measurements, showing the highest predictive value with the average of all measurements (systolic/diastolic hazard ratio per 1-mm Hg increase in BP: 1.021/1.034; systolic/ diastolic 95% CI: 1.012 to 1.030/1.018 to 1.049). However, most of this increase was achieved during the first 3 days of measurement (hazard ratio: 1.017/1.028; 95% CI: 1.009 to 1.026/1.013 to 1.045), and only minimal increase occurred after day 6. No additional benefit was achieved by discarding the values obtained during the first day of measurement. Morning and evening BPs were equally predictive of future cardiovascular events. Novel prognostic data from this study show that measurement of home BP twice in the morning and evening, preferably for a period of 7 days, or for at least 3 days, provides a thorough image of a patient's BP level. This information should be used to prepare a unified international guideline for home BP measurement.
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Affiliation(s)
- Teemu J Niiranen
- Population Studies Unit, National Institute for Health and Welfare, Peltolantie, 20720 Turku, Finland.
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Crucial role of kidney function in resistance to antihypertensive therapy in patients with diabetes mellitus. J Hypertens 2010; 28:2323-8. [DOI: 10.1097/hjh.0b013e32833d025b] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Johansson JK, Niiranen TJ, Puukka PJ, Jula AM. Factors affecting the difference between morning and evening home blood pressure: The Finn-Home study. Blood Press 2010; 20:27-36. [DOI: 10.3109/08037051.2010.518675] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Association of environmental tobacco smoke exposure with elevated home blood pressure in Japanese women: the Ohasama study. J Hypertens 2010; 28:1814-20. [DOI: 10.1097/hjh.0b013e32833a3911] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Morning hypertension assessed by home or ambulatory monitoring: different aspects of the same phenomenon? J Hypertens 2010; 28:1846-53. [DOI: 10.1097/hjh.0b013e32833b497d] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Factors associated with day-by-day variability of self-measured blood pressure at home: the Ohasama study. Am J Hypertens 2010; 23:980-6. [PMID: 20448533 DOI: 10.1038/ajh.2010.94] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND We previously reported that high day-by-day blood pressure (BP) variability derived from self-measured BP at home (home BP) predicted cardiovascular mortality over and beyond other risk factors. The objective of this study is to clarify the determinants of the day-by-day home-BP variability. METHODS We conducted a cross-sectional community survey in 1,215 inhabitants (female gender 59%, mean age 62 years) of Ohasama, Japan. The subjects measured their BP and heart rate once every morning and once every evening for 4 weeks. The day-by-day BP variability and heart rate variability were defined as within individual standard deviation of all home BP and heart rate, respectively. We also considered coefficient of variation (CV). These parameters in the morning and those in the evening were calculated separately. RESULTS The level and standard deviation of home systolic/diastolic BP (SBP/DBP) in the morning were 123.4 +/- 15.1/75.7 +/- 9.0 mm Hg and 8.6 +/- 3.1/5.8 +/- 2.0 mm Hg. Multivariate linear regression analysis demonstrated that older age, female gender, elevated home BP, low home heart rate, and elevated home heart rate variability were significant determinants of elevated home-BP variability. In addition to these factors, alcohol intake and sedentary lifestyle were also determinants of elevated home-BP variability in the evening. CONCLUSIONS Day-by-day home-BP variability was associated with home BP, alcohol intake or sedentary lifestyle. Whether modifying these factors would reduce BP variability and whether such reduction would lead to better outcomes needs further study.
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Matsui Y, Eguchi K, Shibasaki S, Ishikawa J, Shimada K, Kario K. Morning Hypertension Assessed by Home Monitoring Is a Strong Predictor of Concentric Left Ventricular Hypertrophy in Patients With Untreated Hypertension. J Clin Hypertens (Greenwich) 2010; 12:776-83. [DOI: 10.1111/j.1751-7176.2010.00350.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Relationship of dysregulation of glucose metabolism with white-coat hypertension: the Ohasama study. Hypertens Res 2010; 33:937-43. [PMID: 20631718 DOI: 10.1038/hr.2010.114] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Characteristics of glucose metabolism in subjects with white-coat hypertension (WCHT) have not been fully investigated. The purpose of this study was to determine the relationship between glucose metabolism and WCHT on the basis of blood pressure (BP) at home (HBP) in the general population. Participants were from Ohasama, a rural Japanese community, and included 466 residents (mean age, 61.0 years) who had no history of diabetes mellitus. HBP and oral glucose tolerance test values were measured. Participants were classified into four groups on the basis of their HBP and casual-screening BP (CBP) values: normotension (NT) (HBP<135/85 mm Hg, CBP<140/90 mm Hg); WCHT (HBP<135/85 mm Hg, CBP>/=140/90 mm Hg); masked hypertension (HBP>/=135/85 mm Hg, CBP<140/90 mm Hg); or sustained hypertension (SHT) (HBP>/=135/85 mm Hg, CBP>/=140/90 mm Hg). The relationships between glucose metabolism and BP among the four groups were examined using multivariate analysis adjusted for possible confounding factors. Factors in relation to glucose metabolism, such as fasting glucose level, 2-h postchallenge glucose level and homeostasis model assessment-insulin resistance index, were significantly higher in subjects with WCHT and SHT than in those with NT (all P<0.03). When men and women were analyzed separately, these relationships were more pronounced in women. Our results suggest that dysregulation of glucose metabolism in WCHT might contribute to the increase in the long-term cardiovascular risk among the general population.
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Stroke risk in treated hypertension based on home blood pressure: the Ohasama study. Am J Hypertens 2010; 23:508-14. [PMID: 20186131 DOI: 10.1038/ajh.2010.15] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Several observational studies have shown that treated hypertensives are characterized as having worse prognosis than nonhypertensives. However, there is little evidence based on home blood pressure (home BP) measurement. We compare the risk of stroke between untreated individuals and those taking antihypertensive medication based on home BP and casual-screening BP (casual BP) in the general population. METHODS The study included 1,690 untreated and 700 treated subjects aged >or=35 years. We measured home BP and casual BP at the beginning of the study. The risk of first stroke was examined by using the Cox proportional hazards model. RESULTS During 11.9 years of follow-up, we observed 242 first-time stroke cases. Treated subjects had significantly higher risk for stroke than untreated subjects based on home BP (relative hazard (RH) = 1.48) as well as on casual BP (RH = 1.78), adjusted for systolic BP values and characteristics. When subjects were classified into six categories based on BP (optimal, normal, high normal, and grade 1-3 hypertension), RHs in treated hypertensives linearly increased (trend P < 0.01) based on home BP. However, there was no consistent association for casual BP (trend P: not significant) in treated subjects. Stroke risk was linearly increased regardless of the BP information source in untreated subjects (home BP: trend P < 0.01, casual BP: trend P < 0.01). CONCLUSION The results suggest a strong association between elevated home BP and increased risk of stroke. Home BP is a better tool to assess stroke risk, especially in treated hypertensives.
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Home and Office Blood Pressure Control among Treated Hypertensive Patients in Japan: Findings from the Japan Home versus Office Blood Pressure Measurement Evaluation (J-HOME) Study. Pharmaceuticals (Basel) 2010; 3:419-432. [PMID: 27713260 PMCID: PMC4033918 DOI: 10.3390/ph3020419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2009] [Revised: 01/29/2010] [Accepted: 02/02/2010] [Indexed: 11/25/2022] Open
Abstract
Appropriate control of blood pressure (BP) is essential for prevention of future cardiovascular events. However, BP control among treated hypertensive patients has been insufficient. Recently, the usefulness of self-measured BP at home (home BP measurement) for the management of hypertension has been reported in many studies. We evaluated BP control both at home and in the office among treated hypertensive patients in primary care settings in Japan (the J-HOME study). We found poor control of home and office BPs and clarified some factors affecting control. We also examined factors associated with the magnitude of the white-coat effect, the morning–evening BP difference, and home heart rate in this J-HOME study.
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Kawabe H, Saito I, Saruta T. Effects of Nighttime Alcohol Intake on Evening and Next Morning Home Blood Pressure in Japanese Normotensives. Clin Exp Hypertens 2009; 29:43-9. [PMID: 17190730 DOI: 10.1080/10641960601096778] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Home blood pressure (HBP) is usually measured in the morning and evening, but the evening HBP tends to be influenced by an individual's behavior pattern, such as bathing and drinking, which are often seen in the Japanese. In this study, in order to elucidate the influence of nighttime drinking on the evening and next morning HBP and heart rate (HR), HBP measurement was performed in Japanese normotensives under conditions in which the influence of bathing was minimized. Among 700 registered volunteers, 245 normotensives (189 male, 56 female, mean age; 35.8 +/- 0.5 years old) whose data consisted of a combination of drinking and non-drinking on workdays were selected. A semi-automatic device was lent to all participants, and they were asked to perform triplicate morning and evening measurements on seven consecutive days between October 16, 2002, and November 13, 2002. The differences in evening HBP and HR between the drinking and non-drinking days were calculated, as were the differences in the next morning HBP and HR. Only data of evening HBP measured at least 30 min after bathing were accepted. Evening SBP and DBP on drinking days were significantly lower (2.5 +/- 0.5 mmHg, 3.1 +/- 0.5 mmHg) than those on non-drinking days. On the other hand, evening HR on drinking days was significantly higher (7.7 +/- 0.8 b.p.m.) than that on non-drinking days. Although there was no difference in morning SBP after days with and without drinking, morning DBP the day after drinking was slightly (0.8 +/- 0.3 mmHg) but significantly lower than that the day after non-drinking. Morning HR the day after drinking was significantly higher (2.4 +/- 0.4 b.p.m.) than that after non-drinking. Because nighttime drinking influenced the evening HBP even in normotensives, it was suggested that morning HBP could give more stable values than evening HBP in Japanese people.
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Influence of home blood pressure measuring conditions in the evening on the morning–evening home blood pressure difference in treated hypertensive patients: the J-HOME study. Blood Press Monit 2009; 14:160-5. [DOI: 10.1097/mbp.0b013e32832e2a40] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
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Rey E, Morin F, Boudreault J, Pilon F, Vincent D, Ouellet D. Blood Pressure Assessments in Different Subtypes of Hypertensive Pregnant Women: Office Versus Home Patient- or Nurse-Measured Blood Pressure. Hypertens Pregnancy 2009; 28:168-77. [DOI: 10.1080/10641950802233072] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
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Obara T, Ohkubo T, Asayama K, Kikuya M, Metoki H, Inoue R, Komai R, Murai K, Hashimoto J, Totsune K, Imai Y. Prevalence of Masked Hypertension in Subjects Treated with Antihypertensive Drugs as Assessed by Morning versus Evening Home Blood Pressure Measurements: The J-HOME Study. Clin Exp Hypertens 2009; 30:277-87. [DOI: 10.1080/10641960802071018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
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Repeated evening home blood pressure measurement improves prognostic significance for stroke: a 12-year follow-up of the Ohasama study. Blood Press Monit 2009; 14:93-8. [DOI: 10.1097/mbp.0b013e32832a9d91] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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