1
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Shin J, Kario K, Chia Y, Turana Y, Chen C, Buranakitjaroen P, Divinagracia R, Nailes J, Hoshide S, Siddique S, Sison J, Soenarta AA, Sogunuru GP, Tay JC, Teo BW, Zhang Y, Park S, Van Minh H, Kabutoya T, Verma N, Wang T, Wang J. Current status of ambulatory blood pressure monitoring in Asian countries: A report from the HOPE Asia Network. J Clin Hypertens (Greenwich) 2020; 22:384-390. [PMID: 31696632 PMCID: PMC8030038 DOI: 10.1111/jch.13724] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 09/19/2019] [Indexed: 08/02/2023]
Abstract
Ambulatory blood pressure monitoring (ABPM) can measure 24-hour blood pressure (BP), including nocturnal BP and diurnal variations. This feature of ABPM could be of value in Asian populations for preventing cardiovascular events. However, no study has yet investigated regarding the use of ABPM in actual clinical settings in Asian countries/regions. In this study, 11 experts from 11 countries/regions were asked to answer questionnaires regarding the use of ABPM. We found that its use was very limited in primary care settings and almost exclusively available in referral settings. The indications of ABPM in actual clinical settings were largely similar to those of home BP monitoring (HBPM), that is, diagnosis of white-coat or masked hypertension and more accurate BP measurement for borderline clinic BP. Other interesting indications, such as nighttime BP patterns, including non-dipper BP, morning BP surge, and BP variability, were hardly adopted in daily clinical practice. The use of ABPM as treatment guidance for detecting treated but uncontrolled hypertension in the Asian countries/regions didn't seem to be common. The barrier to the use of ABPM was primarily its availability; in referral centers, patient reluctance owing to discomfort or sleep disturbance was the most frequent barrier. ABPM use was significantly more economical when it was reimbursed by public insurance. To facilitate ABPM use, more simplified indications and protocols to minimize discomfort should be sought. For the time being, HBPM could be a reasonable alternative.
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Affiliation(s)
- Jinho Shin
- Division of CardiologyDepartment of Internal MedicineHanyang University Medical CenterSeoulKorea
| | - Kazuomi Kario
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Yook‐Chin Chia
- Department of Medical SciencesSchool of Healthcare and Medical SciencesSunway UniversityBandar SunwayMalaysia
- Department of Primary Care MedicineFaculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Yuda Turana
- Faculty of Medicine and Health SciencesAtma Jaya Catholic University of IndonesiaJakartaIndonesia
| | - Chen‐Huan Chen
- Department of MedicineSchool of MedicineNational Yang‐Ming UniversityTaipeiTaiwan
| | - Peera Buranakitjaroen
- Department of MedicineFaculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Romeo Divinagracia
- University of the East Ramon Magsaysay Memorial Medical Center Inc.Quezon CityPhilippines
| | - Jennifer Nailes
- University of the East Ramon Magsaysay Memorial Medical Center Inc.Quezon CityPhilippines
| | - Satoshi Hoshide
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | | | - Jorge Sison
- Section of CardiologyDepartment of MedicineMedical Center ManilaManilaPhilippines
| | - Arieska Ann Soenarta
- Department of Cardiology and Vascular MedicineFaculty of MedicineUniversity of Indonesia‐National Cardiovascular Center, Harapan KitaJakartaIndonesia
| | - Guru Prasad Sogunuru
- MIOT International HospitalChennaiIndia
- College of Medical SciencesKathmandu UniversityBharatpurNepal
| | - Jam Chin Tay
- Department of General MedicineTan Tock Seng HospitalSingapore CitySingapore
| | - Boon Wee Teo
- Division of Nephrology Department of MedicineYong Loo Lin School of MedicineSingapore CitySingapore
| | - Yu‐Qing Zhang
- Divisions of Hypertension and Heart FailureFu Wai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Sungha Park
- Division of CardiologyCardiovascular HospitalYonsei Health SystemSeoulKorea
| | - Huynh Van Minh
- Department of Internal MedicineUniversity of Medicine and PharmacyHue UniversityHue CityVietnam
| | - Tomoyuki Kabutoya
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Narsingh Verma
- Indian Society of HypertensionKing George's Medical UniversityLucknowIndia
| | - Tzung‐Dau Wang
- Department of Internal MedicineNational Taiwan University College of MedicineTaipei CityTaiwan
| | - Ji‐Guang Wang
- Department of HypertensionCentre for Epidemiological Studies and Clinical TrialsThe Shanghai Institute of HypertensionShanghai Key Laboratory of HypertensionRuijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
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2
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Chia Y, Kario K, Turana Y, Nailes J, Tay JC, Siddique S, Park S, Shin J, Buranakitjaroen P, Chen C, Divinagracia R, Hoshide S, Minh HV, Sison J, Soenarta AA, Sogunuru GP, Sukonthasarn A, Teo BW, Verma N, Zhang Y, Wang T, Wang J. Target blood pressure and control status in Asia. J Clin Hypertens (Greenwich) 2020; 22:344-350. [PMID: 31742891 PMCID: PMC8029870 DOI: 10.1111/jch.13714] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 09/10/2019] [Indexed: 11/29/2022]
Abstract
It is widely accepted that hypertension constitutes a significant cardiovascular risk factor and that treating high blood pressure (BP) effectively reduces cardiovascular risk. An important issue in Asia is not just the high prevalence of hypertension, particularly in some countries, but also the low level of awareness and treatment rates in many regions. The 2017 update of the American College of Cardiology/American Heart Association hypertension guidelines raised the question about which BP threshold should be used to diagnose and treat hypertension. Although there is a theoretical rationale for a stricter BP criterion in Asia given the ethnic-specific features of hypertension in the region, the majority of countries in Asia have retained a diagnostic BP threshold of ≥140/90 mm Hg. Although lowering thresholds might make theoretical sense, this would increase the prevalence of hypertension and also markedly reduce BP control rates. In addition, there are currently no data from robust randomized clinical trials of the benefits of the lower targets in preventing cardiovascular disease and reducing cardiovascular risk, particularly in high-risk patients and especially for Asian populations. There is also no defined home BP treatment target level for an office BP treatment target of 130/80 mm Hg. However, in this regard, in the interim, lifestyle modifications, including reducing body weight and salt intake, should form an important part of hypertension management strategies in Asia, while studies on treating at lower BP threshold level in Asians and getting to lower BP targets will be helpful to inform and optimize the management of hypertension in the region.
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Affiliation(s)
- Yook‐Chin Chia
- Department of Medical SciencesSchool of Healthcare and Medical SciencesSunway UniversityBandar SunwayMalaysia
- Department of Primary Care MedicineFaculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Kazuomi Kario
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Yuda Turana
- Department of NeurologyFaculty of MedicineAtma Jaya Catholic University of IndonesiaJakartaIndonesia
| | - Jennifer Nailes
- University of the East Ramon Magsaysay Memorial Medical Center IncQuezon CityPhilippines
| | - Jam Chin Tay
- Department of General MedicineTan Tock Seng HospitalSingapore CitySingapore
| | | | - Sungha Park
- Division of CardiologyCardiovascular HospitalYonsei Health SystemSeoulKorea
| | - Jinho Shin
- Faculty of Cardiology ServiceHanyang University Medical CenterSeoulKorea
| | - Peera Buranakitjaroen
- Department of MedicineFaculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Chen‐Huan Chen
- Department of MedicineFaculty of MedicineNational Yang‐Ming UniversityTaipeiTaiwan
| | - Romeo Divinagracia
- University of the East Ramon Magsaysay Memorial Medical Center IncQuezon CityPhilippines
| | - Satoshi Hoshide
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Huynh Van Minh
- Department of Internal MedicineUniversity of Medicine and PharmacyHue UniversityHueVietnam
| | - Jorge Sison
- Department of MedicineMedical Center ManilaManilaPhilippines
| | - Arieska Ann Soenarta
- Department Cardiology and Vascular MedicineUniversity of Indonesia‐National Cardiovascular CenterHarapan KitaJakartaIndonesia
| | - Guru Prasad Sogunuru
- MIOT International HospitalChennaiIndia
- College of Medical SciencesKathmandu UniversityBharatpurNepal
| | | | - Boon Wee Teo
- Division of NephrologyDepartment of MedicineYong Loo Lin School of MedicineNational University of SingaporeSingapore CitySingapore
| | - Narsingh Verma
- Department of PhysiologyFaculty of MedicineKing George's Medical UniversityLucknowIndia
| | - Yuqing Zhang
- Divisions of Hypertension and Heart FailureFu Wai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Tzung‐Dau Wang
- Division of CardiologyDepartment of Internal MedicineNational Taiwan University Hospital and College of MedicineNational Taiwan UniversityTaipeiTaiwan
| | - Ji‐Guang Wang
- Department of HypertensionCentre for Epidemiological Studies and Clinical TrialsThe Shanghai Institute of HypertensionShanghai Key Laboratory of HypertensionRuijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
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3
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Sison J, Divinagracia R, Nailes J. Asian management of hypertension: Current status, home blood pressure, and specific concerns in Philippines (a country report). J Clin Hypertens (Greenwich) 2020; 22:504-507. [PMID: 32108413 DOI: 10.1111/jch.13802] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 12/18/2019] [Indexed: 02/01/2023]
Abstract
Incidence of cardiovascular diseases (CVD) in the Philippines based on the Philippine Heart Association survey among hospital-based population showed hypertension as the highest (38.6%), followed by stroke (30%), coronary artery disease (CAD) (17.5%), and heart failure (10.4%). Based on Philippine FNRI data, the prevalence of coronary, cerebrovascular, and peripheral arterial diseases were 1.1%, 0.9%, and 1.0%, respectively. Cardiovascular risk factor prevalence were the following: diabetes at 3.9%, dyslipidemia at 72%, smoking at 31%, obesity at 4.9% (BMI), and 10.2% and 65.6% by waist-hip ratio in men and women, respectively. In a more recent study on risk factors, urban dwellers were more hypertensive, overweight, obese, and with impaired fasting glucose. More smokers and dyslipidemia by high TC, high non-HDL-C, and low HDL-C were seen in those living in the rural areas. Subjects with higher level of education were more overweight, obese and have dyslipidemia by a high TC, TG, and LDL-C while there were more smokers, low HDL-C, and hypertensive participants who have reached a lower level of education. Latest data on prevalence of hypertension were 28% equal for males and females. Unaware was 9%. Treatment rate was 56%, compliance was 57%, and BP control rate was 20%. Antihypertensive medications used were beta-blockers (36%), calcium channel blockers (CCB) (33%), angiotensin receptor blockers (ARB) (28%), ACE inhibitors (5%), and centrally acting agents (4%). Mortality from CVD was stroke, mostly infarct (22.6%), myocardial infarction (6.5%), and Heart Failure (6.5%).
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Affiliation(s)
- Jorge Sison
- Section of Cardiology, Department of Medicine, Medical Center Manila, Manila, Philippines
| | - Romeo Divinagracia
- University of the East Ramon Magsaysay Memorial Medical Center Inc., Quezon City, Philippines
| | - Jennifer Nailes
- University of the East Ramon Magsaysay Memorial Medical Center Inc., Quezon City, Philippines
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4
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Cheng HM, Chuang SY, Wang TD, Kario K, Buranakitjaroen P, Chia YC, Divinagracia R, Hoshide S, Minh HV, Nailes J, Park S, Shin J, Siddique S, Sison J, Soenarta AA, Sogunuru GP, Sukonthasarn A, Tay JC, Teo BW, Turana Y, Verma N, Zhang Y, Wang JG, Chen CH. Central blood pressure for the management of hypertension: Is it a practical clinical tool in current practice? J Clin Hypertens (Greenwich) 2019; 22:391-406. [PMID: 31841279 DOI: 10.1111/jch.13758] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 11/12/2019] [Accepted: 11/17/2019] [Indexed: 12/31/2022]
Abstract
Since noninvasive central blood pressure (BP) measuring devices are readily available, central BP has gained growing attention regarding its clinical application in the management of hypertension. The disagreement between central and peripheral BP has long been recognized. Some previous studies showed that noninvasive central BP may be better than the conventional brachial BP in association with target organ damages and long-term cardiovascular outcomes. Recent studies further suggest that the central BP strategy for confirming a diagnosis of hypertension may be more cost-effective than the conventional strategy, and guidance of hypertension management with central BP may result in less use of medications to achieve BP control. Despite the use of central BP being promising, more randomized controlled studies comparing central BP-guided therapeutic strategies with conventional care for cardiovascular events reduction are required because noninvasive central and brachial BP measures are conveniently available. In this brief review, the rationale supporting the utility of central BP in clinical practice and relating challenges are summarized.
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Affiliation(s)
- Hao-Min Cheng
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Center for Evidence-Based Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Public Health, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Shao-Yuan Chuang
- Institute of Population Health Science, National Health Research Institutes, Miaoli, Taiwan
| | - Tzung-Dau Wang
- Department of Internal Medicine, National Taiwan University College of Medicine, Taipei City, Taiwan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Peera Buranakitjaroen
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Yook-Chin Chia
- Department of Medical Sciences, School of Healthcare and Medical Sciences, Sunway University, Bandar Sunway, Malaysia.,Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Romeo Divinagracia
- University of the East Ramon Magsaysay Memorial Medical Center Inc, Quezon City, Philippines
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Huynh Van Minh
- Department of Internal Medicine, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Jennifer Nailes
- University of the East Ramon Magsaysay Memorial Medical Center Inc, Quezon City, Philippines
| | - Sungha Park
- Division of Cardiology, Cardiovascular Hospital, Yonsei Health System, Seoul, Korea
| | - Jinho Shin
- Faculty of Cardiology Service, Hanyang University Medical Center, Seoul, Korea
| | | | - Jorge Sison
- Section of Cardiology, Department of Medicine, Medical Center Manila, Manila, Philippines
| | - Arieska Ann Soenarta
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia-National Cardiovascular Center, Jakarta, Indonesia
| | - Guru Prasad Sogunuru
- MIOT International Hospital, Chennai, India.,College of Medical Sciences, Kathmandu University, Bharatpur, Nepal
| | - Apichard Sukonthasarn
- Cardiology Division, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Jam Chin Tay
- Department of General Medicine, Tan Tock Seng Hospital, Singapore, Singapore
| | - Boon Wee Teo
- Division of Nephrology, Department of Medicine, Yong Loo Lin School of Medicine, Singapore, Singapore
| | - Yuda Turana
- Faculty of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Narsingh Verma
- Indian Society of Hypertension, King George's Medical University, Lucknow, India
| | - Yuqing Zhang
- Divisions of Hypertension and Heart Failure, Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ji-Guang Wang
- Department of Hypertension, Centre for Epidemiological Studies and Clinical Trials, the Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Chen-Huan Chen
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Center for Evidence-Based Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
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5
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Kario K, Park S, Chia Y, Sukonthasarn A, Turana Y, Shin J, Chen C, Buranakitjaroen P, Divinagracia R, Nailes J, Hoshide S, Siddique S, Sison J, Soenarta AA, Sogunuru GP, Tay JC, Teo BW, Zhang Y, Van Minh H, Tomitani N, Kabutoya T, Verma N, Wang T, Wang J. 2020 Consensus summary on the management of hypertension in Asia from the HOPE Asia Network. J Clin Hypertens (Greenwich) 2019; 22:351-362. [DOI: 10.1111/jch.13751] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 11/04/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Kazuomi Kario
- Division of Cardiovascular Medicine Department of Medicine Jichi Medical University School of Medicine Tochigi Japan
| | - Sungha Park
- Division of Cardiology Cardiovascular Hospital Yonsei Health System Seoul Korea
| | - Yook‐Chin Chia
- Department of Medical Sciences School of Healthcare and Medical Sciences Sunway University Selangor Darul Ehsan Bandar Sunway Malaysia
- Department of Primary Care Medicine Faculty of Medicine University of Malaya Kuala Lumpur Malaysia
| | - Apichard Sukonthasarn
- Cardiology Division Department of Internal Medicine Faculty of Medicine Chiang Mai University Chiang Mai Thailand
| | - Yuda Turana
- Faculty of Medicine and Health Sciences Atma Jaya Catholic University of Indonesia Jakarta Indonesia
| | - Jinho Shin
- Faculty of Cardiology Service Hanyang University Medical Center Seoul Korea
| | - Chen‐Huan Chen
- Department of Medicine School of Medicine National Yang‐Ming University Taipei Taiwan
| | - Peera Buranakitjaroen
- Department of Medicine Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand
| | - Romeo Divinagracia
- University of the East Ramon Magsaysay Memorial Medical Center Inc. Quezon City Philippines
| | - Jennifer Nailes
- University of the East Ramon Magsaysay Memorial Medical Center Inc. Quezon City Philippines
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine Department of Medicine Jichi Medical University School of Medicine Tochigi Japan
| | | | - Jorge Sison
- Section of Cardiology Department of Medicine Medical Center Manila Manila Philippines
| | - Arieska Ann Soenarta
- Department of Cardiology and Vascular Medicine Faculty of Medicine University of Indonesia‐National Cardiovascular Center, Harapan Kita Jakarta Indonesia
| | - Guru Prasad Sogunuru
- MIOT International Hospital Chennai India
- College of Medical Sciences Kathmandu University Bharatpur Nepal
| | - Jam Chin Tay
- Department of General Medicine Tan Tock Seng Hospital Singapore City Singapore
| | - Boon Wee Teo
- Division of Nephrology Department of Medicine Yong Loo Lin School of Medicine National University of Singapore Singapore City Singapore
| | - Yu‐Qing Zhang
- Divisions of Hypertension and Heart Failure Fu Wai Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China
| | - Huynh Van Minh
- Department of Internal Medicine University of Medicine and Pharmacy Hue University Hue Vietnam
| | - Naoko Tomitani
- Division of Cardiovascular Medicine Department of Medicine Jichi Medical University School of Medicine Tochigi Japan
| | - Tomoyuki Kabutoya
- Division of Cardiovascular Medicine Department of Medicine Jichi Medical University School of Medicine Tochigi Japan
| | - Narsingh Verma
- King George's Medical University Uttar Pradesh Chowk, Lucknow India
| | - Tzung‐Dau Wang
- Cardiovascular Center and Division of Cardiology Department of Internal Medicine National Taiwan University Hospital and National Taiwan University College of Medicine Taipei City Taiwan
| | - Ji‐Guang Wang
- Department of Hypertension, Centre for Epidemiological Studies and Clinical Trials, the Shanghai Institute of Hypertension Shanghai Key Laboratory of Hypertension Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai China
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6
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Kario K, Shin J, Chen C, Buranakitjaroen P, Chia Y, Divinagracia R, Nailes J, Hoshide S, Siddique S, Sison J, Soenarta AA, Sogunuru GP, Tay JC, Teo BW, Turana Y, Zhang Y, Park S, Van Minh H, Wang J. Expert panel consensus recommendations for ambulatory blood pressure monitoring in Asia: The HOPE Asia Network. J Clin Hypertens (Greenwich) 2019; 21:1250-1283. [PMID: 31532913 PMCID: PMC8030405 DOI: 10.1111/jch.13652] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 07/07/2019] [Indexed: 01/03/2023]
Abstract
Hypertension is an important public health issue because of its association with a number of significant diseases and adverse outcomes. However, there are important ethnic differences in the pathogenesis and cardio-/cerebrovascular consequences of hypertension. Given the large populations and rapidly aging demographic in Asian regions, optimal strategies to diagnose and manage hypertension are of high importance. Ambulatory blood pressure monitoring (ABPM) is an important out-of-office blood pressure (BP) measurement tool that should play a central role in hypertension detection and management. The use of ABPM is particularly important in Asia due to the specific features of hypertension in Asian patients, including a high prevalence of masked hypertension, disrupted BP variability with marked morning BP surge, and nocturnal hypertension. This HOPE Asia Network document summarizes region-specific literature on the relationship between ABPM parameters and cardiovascular risk and target organ damage, providing a rationale for consensus-based recommendations on the use of ABPM in Asia. The aim of these recommendations is to guide and improve clinical practice to facilitate optimal BP monitoring with the goal of optimizing patient management and expediting the efficient allocation of treatment and health care resources. This should contribute to the HOPE Asia Network mission of improving the management of hypertension and organ protection toward achieving "zero" cardiovascular events in Asia.
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Affiliation(s)
- Kazuomi Kario
- Division of Cardiovascular Medicine, Department of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Jinho Shin
- Faculty of Cardiology ServiceHanyang University Medical CenterSeoulKorea
| | - Chen‐Huan Chen
- Department of MedicineSchool of Medicine National Yang‐Ming UniversityTaipeiTaiwan
| | - Peera Buranakitjaroen
- Department of Medicine, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Yook‐Chin Chia
- Department of Medical Sciences, School of Healthcare and Medical SciencesSunway UniversityBandar SunwayMalaysia
- Department of Primary Care Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Romeo Divinagracia
- University of the East Ramon Magsaysay Memorial Medical Center Inc.Quezon CityPhilippines
| | - Jennifer Nailes
- University of the East Ramon Magsaysay Memorial Medical Center Inc.Quezon CityPhilippines
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of MedicineJichi Medical University School of MedicineTochigiJapan
| | | | - Jorge Sison
- Section of Cardiology, Department of MedicineMedical Center ManilaManilaPhilippines
| | - Arieska Ann Soenarta
- Department of Cardiology and Vascular Medicine, Faculty of MedicineUniversity of Indonesia‐National Cardiovascular Center, Harapan KitaJakartaIndonesia
| | - Guru Prasad Sogunuru
- MIOT International HospitalChennaiIndia
- College of Medical SciencesKathmandu UniversityBharatpurNepal
| | - Jam Chin Tay
- Department of General MedicineTan Tock Seng HospitalSingaporeSingapore
| | - Boon Wee Teo
- Division of Nephrology, Department of MedicineYong Loo Lin School of MedicineSingaporeSingapore
| | - Yuda Turana
- Faculty of Medicine and Health SciencesAtma Jaya Catholic University of IndonesiaJakartaIndonesia
| | - Yuqing Zhang
- Divisions of Hypertension and Heart Failure, Fu Wai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Sungha Park
- Division of Cardiology, Cardiovascular HospitalYonsei Health SystemSeoulKorea
| | - Huynh Van Minh
- Department of Internal Medicine, University of Medicine and PharmacyHue UniversityHueVietnam
| | - Ji‐Guang Wang
- Department of Hypertension, Centre for Epidemiological Studies and Clinical Trials, The Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
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7
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Sogunuru GP, Kario K, Shin J, Chen C, Buranakitjaroen P, Chia YC, Divinagracia R, Nailes J, Park S, Siddique S, Sison J, Soenarta AA, Tay JC, Turana Y, Zhang Y, Hoshide S, Wang J. Morning surge in blood pressure and blood pressure variability in Asia: Evidence and statement from the HOPE Asia Network. J Clin Hypertens (Greenwich) 2019; 21:324-334. [PMID: 30525279 PMCID: PMC8030409 DOI: 10.1111/jch.13451] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 10/05/2018] [Indexed: 08/02/2023]
Abstract
Hypertension is a major risk factor for cardiovascular and cerebrovascular diseases. To effectively prevent end-organ damage, maintain vascular integrity and reduce morbidity and mortality, it is essential to decrease and adequately control blood pressure (BP) throughout each 24-hour period. Exaggerated early morning BP surge (EMBS) is one component of BP variability (BPV), and has been associated with an increased risk of stroke and cardiovascular events, independently of 24-hour average BP. BPV includes circadian, short-term and long-term components, and can best be documented using out-of-office techniques such as ambulatory and/or home BP monitoring. There is a large body of evidence linking both BPV and EMBS with increased rates of adverse cardio- and cerebrovascular events, and end-organ damage. Differences in hypertension and related cardiovascular disease rates have been reported between Western and Asian populations, including a higher rate of stroke, higher prevalence of metabolic syndrome, greater salt sensitivity and more common high morning and nocturnal BP readings in Asians. This highlights a need for BP management strategies that take into account ethnic differences. In general, long-acting antihypertensives that control BP throughout the 24-hour period are preferred; amlodipine and telmisartan have been shown to control EMBS more effectively than valsartan. Home and ambulatory BP monitoring should form an essential part of hypertension management, with individualized pharmacotherapy to achieve optimal 24-hour BP control particularly the EMBS and provide the best cardio- and cerebrovascular protection. Future research should facilitate better understanding of BPV, allowing optimization of strategies for the detection and treatment of hypertension to reduce adverse outcomes.
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Affiliation(s)
- Guru P. Sogunuru
- MIOT International HospitalChennaiIndia
- College of Medical SciencesKathmandu UniversityBharatpurNepal
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Jinho Shin
- Faculty of Cardiology ServiceHanyang University Medical CenterSeoulKorea
| | - Chen‐Huan Chen
- Department of MedicineFaculty of Medicine, National Yang‐Ming UniversityTaipeiTaiwan
| | - Peera Buranakitjaroen
- Department of MedicineFaculty of Medicine Siriraj Hospital, Mahidol UniversityBangkokThailand
| | - Yook C. Chia
- Depatment of Medical Sciences, School of Healthcare and Medical SciencesSunway UniversityBandar SunwaySelangor Darul EhsanMalaysia
| | - Romeo Divinagracia
- University of the East Ramon Magsaysay Memorial Medical Center IncQuezon CityPhilippines
| | - Jennifer Nailes
- University of the East Ramon Magsaysay Memorial Medical Center IncQuezon CityPhilippines
| | - Sungha Park
- Division of CardiologyCardiovascular Hospital, Yonsei Health SystemSeoulKorea
| | | | - Jorge Sison
- Department of MedicineMedical Center ManilaManilaPhilippines
| | - Arieska A. Soenarta
- Department Cardiology and Vascular MedicineUniversity of Indonesia‐National Cardiovascular Center, Harapan KitaJakartaIndonesia
| | - Jam C. Tay
- Department of General MedicineTan Tock Seng HospitalSingaporeSingapore
| | - Yuda Turana
- Department of NeurologyFaculty of Medicine, Atma Jaya Catholic University of IndonesiaJakartaIndonesia
| | - Yuqing Zhang
- Divisions of Hypertension and Heart FailureFu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Ji‐Guang Wang
- Department of Hypertension, Centre for Epidemiological Studies and Clinical TrialsThe Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
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8
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Kario K, Tomitani N, Buranakitjaroen P, Chia YC, Park S, Chen CH, Divinagracia R, Shin J, Siddique S, Sison J, Ann Soenarta A, Sogunuru GP, Tay JC, Turana Y, Zhang Y, Nailes J, Wanthong S, Hoshide S, Matsushita N, Kanegae H, Wang JG. Home blood pressure control status in 2017-2018 for hypertension specialist centers in Asia: Results of the Asia BP@Home study. J Clin Hypertens (Greenwich) 2018; 20:1686-1695. [PMID: 30444315 DOI: 10.1111/jch.13415] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 09/03/2018] [Accepted: 09/07/2018] [Indexed: 12/23/2022]
Abstract
A self-measured home blood pressure (BP)-guided strategy is an effective practical approach to hypertension management. The Asia BP@Home study is the first designed to investigate current home BP control status in different Asian countries/regions using standardized home BP measurements taken with the same validated home BP monitoring device with data memory. We enrolled 1443 medicated hypertensive patients from 15 Asian specialist centers in 11 countries/regions between April 2017 and March 2018. BP was relatively well controlled in 68.2% of patients using a morning home systolic BP (SBP) cutoff of <135 mm Hg, and in 55.1% of patients using a clinic SBP cutoff of <140 mm Hg. When cutoff values were changed to the 2017 AHA/ACC threshold (SBP <130 mm Hg), 53.6% of patients were well controlled for morning home SBP. Using clinic 140 mm Hg and morning home 135 mm Hg SBP thresholds, the proportion of patients with well-controlled hypertension (46%) was higher than for uncontrolled sustained (22%), white-coat (23%), and masked uncontrolled (9%) hypertension, with significant country/regional differences. Home BP variability in Asian countries was high, and varied by country/region. In conclusion, the Asia BP@Home study demonstrated that home BP is relatively well controlled at hypertension specialist centers in Asia. However, almost half of patients remain uncontrolled for morning BP according to new guidelines, with significant country/regional differences. Strict home BP control should be beneficial in Asian populations. The findings of this study are important to facilitate development of health policies focused on reducing cardiovascular complications in Asia.
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Affiliation(s)
- Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Naoko Tomitani
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Peera Buranakitjaroen
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Yook-Chin Chia
- Department of Medical Sciences, School of Healthcare and Medical Sciences, Sunway University, Bandar Sunway, Selangor Darul Ehsan, Malaysia.,Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Sungha Park
- Division of Cardiology, Cardiovascular Hospital, Yonsei Health System, Seoul, Korea
| | - Chen-Huan Chen
- Department of Medicine, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Romeo Divinagracia
- University of the East Ramon Magsaysay Memorial Medical Center Inc, Quezon City, Philippines
| | - Jinho Shin
- Faculty of Cardiology Service, Hanyang University Medical Center, Seoul, Korea
| | | | - Jorge Sison
- Department of Medicine, Medical Center Manila, Ermita, Manila, Philippines
| | - Arieska Ann Soenarta
- Department of Cardiology and Vascular Medicine, University of Indonesia-National Cardiovascular Center, Harapan Kita, Jakarta, Indonesia
| | - Guru Prasad Sogunuru
- MIOT International Hospital, Chennai, India.,College of Medical Sciences, Kathmandu University, Bharatpur, Nepal
| | - Jam Chin Tay
- Department of General Medicine, Tan Tock Seng Hospital, Singapore, Singapore
| | - Yuda Turana
- Department of Neurology, Faculty of Medicine, Atma Jaya Catholic University of Indonesia, North Jakarta, Jakarta, Indonesia
| | - Yuqing Zhang
- Divisions of Hypertension and Heart Failure, Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jennifer Nailes
- University of the East Ramon Magsaysay Memorial Medical Center Inc, Quezon City, Philippines
| | - Sirisawat Wanthong
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.,Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | | | - Hiroshi Kanegae
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Ji-Guang Wang
- Department of Hypertension, Centre for Epidemiological Studies and Clinical Trials, The Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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9
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Park S, Buranakitjaroen P, Chen CH, Chia YC, Divinagracia R, Hoshide S, Shin J, Siddique S, Sison J, Soenarta AA, Sogunuru GP, Tay JC, Turana Y, Wang JG, Zhang Y, Kario K. Expert panel consensus recommendations for home blood pressure monitoring in Asia: the Hope Asia Network. J Hum Hypertens 2018; 32:249-258. [PMID: 29386668 DOI: 10.1038/s41371-017-0025-y] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 09/12/2017] [Accepted: 10/04/2017] [Indexed: 12/11/2022]
Abstract
Hypertension is the leading cause of mortality throughout Asia. Home blood pressure monitoring has the potential to improve hypertension control and is a useful adjunct to conventional office blood pressure measurements due to its diagnostic accuracy and prognostic value in predicting cardiovascular outcomes. At present, there are no region-specific guidelines addressing the use of home blood pressure monitoring in Asia. Therefore, an expert panel was convened to address the use of home blood pressure monitoring and develop key recommendations to help guide clinical practice throughout the Asia region. The resulting recommendations support the use of home blood pressure monitoring with a validated device as an accurate adjunct for diagnosing hypertension and predicting cardiovascular outcome. Diagnosis and treatment of hypertension should still be guided by conventional office/clinic blood pressure measurements. The expert panel encourages the incorporation of home blood pressure monitoring into local clinical guidelines and offers practical recommendations to ensure continuity of care where a validated home blood pressure device is not available.
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Affiliation(s)
- Sungha Park
- Division of Cardiology, Cardiovascular Hospital, Yonsei Health System, Seoul, Korea
| | - Peera Buranakitjaroen
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
| | - Chen-Huan Chen
- Department of Medicine, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yook-Chin Chia
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Sunway lnstitute for Healthcare Development, Sunway University, Selangor Darul Ehsan, Malaysia
| | - Romeo Divinagracia
- University of the East Ramon Magsaysay Memorial Medical Center Inc, Quezon City, Philippines
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Jinho Shin
- Faculty of Cardiology Service, Hanyang University Medical Center, Seongdong, Seoul, Korea
| | | | - Jorge Sison
- Section of Cardiology, Department of Medicine, Medical Center Manila, Manila, Philippines
| | - Arieska Ann Soenarta
- Department of Cardiology and Vascular Medicine, University of Indonesia-National Cardiovascular Center, Harapan Kita, Jakarta, Indonesia
| | - Guru Prasad Sogunuru
- Apollo Hospitals, Chennai, India
- College of Medical Sciences, Kathmandu University, Bharatpur, Nepal
| | - Jam Chin Tay
- Department of General Medicine, Tan Tock Seng Hospital, Singapore, Singapore
| | - Yuda Turana
- Department of Neurology, Faculty of Medicine, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Ji-Guang Wang
- Department of Hypertension, Centre for Epidemiological Studies and Clinical Trials, The Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yuqing Zhang
- Divisions of Hypertension and Heart Failure, Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
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10
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Kario K, Park S, Buranakitjaroen P, Chia Y, Chen C, Divinagracia R, Hoshide S, Shin J, Siddique S, Sison J, Soenarta AA, Sogunuru GP, Tay JC, Turana Y, Wong L, Zhang Y, Wang J. Guidance on home blood pressure monitoring: A statement of the HOPE Asia Network. J Clin Hypertens (Greenwich) 2018; 20:456-461. [PMID: 29450979 PMCID: PMC8031139 DOI: 10.1111/jch.13216] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Revised: 11/28/2017] [Accepted: 12/13/2017] [Indexed: 08/01/2023]
Abstract
Hypertension is an important modifiable cardiovascular risk factor and a leading cause of death throughout Asia. Effective prevention and control of hypertension in the region remain a significant challenge despite the availability of several regional and international guidelines. Out-of-office measurement of blood pressure (BP), including home BP monitoring (HBPM), is an important hypertension management tool. Home BP is better than office BP for predicting cardiovascular risk and HBPM should be considered for all patients with office BP ≥ 130/85 mm Hg. It is important that HBPM is undertaken using a validated device and patients are educated about how to perform HBPM correctly. During antihypertensive therapy, monitoring of home BP control and variability is essential, especially in the morning. This is because HBPM can facilitate the choice of individualized optimal therapy. The evidence and practice points in this document are based on the Hypertension Cardiovascular Outcome Prevention and Evidence (HOPE) Asia Network expert panel consensus recommendations for HBPM in Asia.
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Affiliation(s)
- Kazuomi Kario
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Sungha Park
- Division of CardiologyCardiovascular HospitalYonsei Health SystemSeoulKorea
| | - Peera Buranakitjaroen
- Department of MedicineFaculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Yook‐Chin Chia
- Department of Primary Care MedicineFaculty of MedicineUniversity of Malaya KualaLumpurMalaysia
- Sunway Institute for Healthcare DevelopmentSunway UniversitySubang JayaSelangor Darul EhsanMalaysia
| | - Chen‐Huan Chen
- Department of MedicineFaculty of Medicine National Yang‐Ming UniversityTaipeiTaiwan
| | - Romeo Divinagracia
- University of the East Ramon Magsaysay Memorial Medical Center IncQuezon CityPhilippines
| | - Satoshi Hoshide
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Jinho Shin
- Faculty of Cardiology ServiceHanyang University Medical CenterSeoulKorea
| | | | - Jorge Sison
- Section of CardiologyDepartment of MedicineMedical Center ManilaManilaPhilippines
| | - Arieska Ann Soenarta
- Department Cardiology and Vascular MedicineFaculty of MedicineUniversity of Indonesia‐National Cardiovascular Center Harapan KitaJakartaIndonesia
| | - Guru Prasad Sogunuru
- Apollo HospitalsChennaiIndia
- College of Medical SciencesKathmandu UniversityBharatpurNepal
| | - Jam Chin Tay
- Department of General MedicineTan Tock Seng HospitalSingaporeSingapore
| | - Yuda Turana
- Department of NeurologyFaculty of MedicineAtma Jaya Catholic University of IndonesiaJakartaIndonesia
| | - Lawrence Wong
- Department of Medicine & TherapeuticsDivision of NeurologyChinese University of Hong KongHong Kong
| | - Yuqing Zhang
- Divisions of Hypertension and Heart FailureFu Wai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Ji‐Guang Wang
- Department of HypertensionCentre for Epidemiological Studies and Clinical TrialsThe Shanghai Institute of HypertensionShanghai Key Laboratory of HypertensionRuijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
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11
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Kario K, Tomitani N, Buranakitjaroen P, Chen C, Chia Y, Divinagracia R, Park S, Shin J, Siddique S, Sison J, Soenarta AA, Sogunuru GP, Tay JC, Turana Y, Wang J, Wong L, Zhang Y, Wanthong S, Hoshide S, Kanegae H. Rationale and design for the Asia BP@Home study on home blood pressure control status in 12 Asian countries and regions. J Clin Hypertens (Greenwich) 2018; 20:33-38. [PMID: 29265725 PMCID: PMC8030943 DOI: 10.1111/jch.13145] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 09/11/2017] [Accepted: 09/22/2017] [Indexed: 01/04/2023]
Abstract
Home blood pressure (BP) monitoring is endorsed in multiple guidelines as a valuable adjunct to office BP measurements for the diagnosis and management of hypertension. In many countries throughout Asia, physicians are yet to appreciate the significant contribution of BP variability to cardiovascular events. Furthermore, data from Japanese cohort studies have shown that there is a strong association between morning BP surge and cardiovascular events, suggesting that Asians in general may benefit from more effective control of morning BP. We designed the Asia BP@Home study to investigate the distribution of hypertension subtypes, including white-coat hypertension, masked morning hypertension, and well-controlled and uncontrolled hypertension. The study will also investigate the determinants of home BP control status evaluated by the same validated home BP monitoring device and the same standardized method of home BP measurement among 1600 or more medicated patients with hypertension from 12 countries/regions across Asia.
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Affiliation(s)
- Kazuomi Kario
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Naoko Tomitani
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Peera Buranakitjaroen
- Department of MedicineFaculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Chen‐Huan Chen
- Department of MedicineFaculty of MedicineNational Yang‐Ming UniversityTaipeiTaiwan
| | - Yook‐Chin Chia
- Department of Primary Care MedicineFaculty of MedicineUniversity of MalayaKuala LumpurMalaysia
- Sunway Institute for Healthcare DevelopmentSunway UniversitySelangor Darul EhsanMalaysia
| | - Romeo Divinagracia
- University of the East Ramon Magsaysay Memorial Medical Center IncQuezon CityPhilippines
| | - Sungha Park
- Division of CardiologyCardiovascular HospitalYonsei Health SystemSeoulKorea
| | - Jinho Shin
- Faculty of Cardiology ServiceHanyang University Medical CenterSeoulKorea
| | | | - Jorge Sison
- Department of MedicineMedical Center ManilaErmita, ManilaPhilippines
| | - Arieska Ann Soenarta
- Department of Cardiology and Vascular MedicineUniversity of Indonesia‐National Cardiovascular CenterHarapan Kita, JakartaIndonesia
| | - Guru Prasad Sogunuru
- Apollo HospitalsChennaiIndia
- College of Medical SciencesKathmandu UniversityBharatpurNepal
| | - Jam Chin Tay
- Department of General MedicineTan Tock Seng HospitalSingaporeSingapore
| | - Yuda Turana
- Department of NeurologyFaculty of MedicineAtma Jaya Catholic University of IndonesiaNorth Jakarta, JakartaIndonesia
| | - Ji‐Guang Wang
- Department of HypertensionCentre for Epidemiological Studies and Clinical TrialsThe Shanghai Institute of HypertensionShanghai Key Laboratory of HypertensionRuijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Lawrence Wong
- Department of Medicine and TherapeuticsDivision of Neurology, Chinese University of Hong KongHong Kong
| | - Yuqing Zhang
- Divisions of Hypertension and Heart FailureFu Wai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Sirisawat Wanthong
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
- Department of MedicineFaculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Satoshi Hoshide
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
| | - Hiroshi Kanegae
- Division of Cardiovascular MedicineDepartment of MedicineJichi Medical University School of MedicineTochigiJapan
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12
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Chia YC, Buranakitjaroen P, Chen CH, Divinagracia R, Hoshide S, Park S, Shin J, Siddique S, Sison J, Soenarta AA, Sogunuru GP, Tay JC, Turana Y, Wang JG, Wong L, Zhang Y, Kario K. Current status of home blood pressure monitoring in Asia: Statement from the HOPE Asia Network. J Clin Hypertens (Greenwich) 2017; 19:1192-1201. [PMID: 28815840 DOI: 10.1111/jch.13058] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 05/25/2017] [Accepted: 05/29/2017] [Indexed: 12/15/2022]
Abstract
Hypertension represents a major burden in Asia, with a high prevalence rate but poor level of awareness and control reported in many countries in the region. Home blood pressure monitoring has been validated as an accurate and reliable measure of blood pressure that can help guide hypertension treatment as well as identify masked and white-coat hypertension. Despite its benefits, there has been limited research into home blood pressure monitoring in Asia. The authors reviewed the current evidence on home blood pressure monitoring in Asia, including but not limited to published literature, data presented at congresses, and national hypertension management guidelines to determine the current utilization of home blood pressure monitoring in clinical practice in the region. Public policies to enable greater access to home blood pressure monitoring and its use in clinical care would add considerably to improving hypertension outcomes in Asia.
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Affiliation(s)
- Yook-Chin Chia
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Sunway lnstitute for Healthcare Development, Sunway University, Selangor Darul Ehsan, Malaysia
| | - Peera Buranakitjaroen
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chen-Huan Chen
- Department of Medicine, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Romeo Divinagracia
- University of the East Ramon Magsaysay Memorial Medical Center Inc, Quezon City, Philippines
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Sungha Park
- Division of Cardiology, Cardiovascular Hospital, Yonsei Health System, Seoul, Korea
| | - Jinho Shin
- Faculty of Cardiology Service, Hanyang University Medical Center, Seongdong, Seoul, Korea
| | | | - Jorge Sison
- Department of Medicine, Medical Center Manila, Ermita, Manila, Philippines
| | - Arieska Ann Soenarta
- Department Cardiology and Vascular Medicine, Faculty of Medicine, Harapan Kita, University of Indonesia-National Cardiovascular Center, Jakarta, Indonesia
| | - Guru Prasad Sogunuru
- Apollo Hospitals, Chennai, India.,College of Medical Sciences, Kathmandu University, Bharatpur, Nepal
| | - Jam Chin Tay
- Department of General Medicine, Tan Tock Seng Hospital, Singapore, Singapore
| | - Yuda Turana
- Department of Neurology, Faculty of Medicine, Atma Jaya Catholic University of Indonesia, North Jakarta, Jakarta, Indonesia
| | - Ji-Guang Wang
- Department of Hypertension, Centre for Epidemiological Studies and Clinical Trials, The Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Lawrence Wong
- Department of Medicine & Therapeutics, Division of Neurology, Chinese University of Hong Kong, Hong Kong
| | - Yuqing Zhang
- Divisions of Hypertension and Heart Failure, Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
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13
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Gaw AC, Lee B, Gervacio-Domingo G, Antzelevitch C, Divinagracia R, Jocano F. Unraveling the Enigma of Bangungut: Is Sudden Unexplained Nocturnal Death Syndrome (SUNDS) in the Philippines a Disease Allelic to the Brugada Syndrome? Philipp J Intern Med 2011; 49:165-176. [PMID: 22844180 PMCID: PMC3404490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND: Sudden unexplained nocturnal death syndrome (SUNDS) has been reported worldwide. SUNDS is endemic in Southeast Asia and is colloquially known as Bangungut in the Philippines, Lai Tai in Thailand, and Pokkuri in Japan. Although SUNDS in Thailand and Japan have been determined to be phenotypically, genetically and functionally identical to the Brugada syndrome, the relationship between Bangungut/SUNDS in the Philippines and the Brugada syndrome has not been clarified. This paper explores the concordance between Bangungut/SUNDS and the Brugada syndrome. METHODS: We summarized autopsy studies on Bangungut retrieved from PubMed since 1917 and current epidemiological data on Philippine SUNDS to clarify its diagnostic features. We also reviewed current hypotheses of the pathophysiological mechanism of the Brugada syndrome to explore its applicability to Bangungut/SUNDS. RESULTS: The use of the term Bangungut is confusing as it includes many diseases that may cause SUNDS. However, our review reveals a notable subset of Bangungut, identified as Bangungut/SUNDS with no gross cardiac pathology that conforms to the clinical picture of the folk-belief of Bangungut and of the Brugada syndrome, namely: predominance among male in the 20-40 age range; sudden death during sleep or at rest, usually following ingestion of a large meal at night; and victims were in apparent good health prior to their demise. Current pathophysiological mechanisms of Brugada syndrome seemed plausible explanations for a majority of this subset of Bangungut/SUNDS. CONCLUSION: Bangungut/SUNDS and the Brugada syndrome appear closely related. Pathophysiological mechanisms of the Brugada syndrome may explain the enigma of Bangungut/SUND. Whether Bangungut/SUNDS is phenotypically, genetically and functionally an allele of the Brugada syndrome remains inconclusive due to lack of research data. We therefore proposed a research agenda including genetic testing and pharmacological challenge of probands and their family members suspected of SUNDS to conclusively establish the relationship between these two syndromes.
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Affiliation(s)
- Albert C. Gaw
- Department of Psychiatry, University of California, San Francisco
| | - Byron Lee
- Cardiac Electrophysiology and Arrhythmia Section, University of California, San Francisco
| | | | | | - Romeo Divinagracia
- University of the East, Ramon Magsaysay Memorial Medical Center, Inc., Quezon City, Philippines
| | - Felipe Jocano
- Department of Anthropology, University of the Philippines, Diliman, Quezon City, Philippines
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