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Nighttime Blood Pressure Measured by Home Blood Pressure Monitoring as an Independent Predictor of Cardiovascular Events in General Practice.

Publication ,  Journal Article
Kario, K; Kanegae, H; Tomitani, N; Okawara, Y; Fujiwara, T; Yano, Y; Hoshide, S
Published in: Hypertension
June 2019

We developed an innovative automated home blood pressure (BP) monitoring method that measures BP while asleep repeatedly over several days. Our aim was to assess the predictive ability of nighttime BP obtained using the home BP device for incident cardiovascular disease (CVD) in general practice patients. We used data from the nationwide practice-based J-HOP (Japan Morning Surge-Home Blood Pressure) Nocturnal BP Study, which recruited 2545 Japanese with a history of or risk factors for CVD (mean age 63 years; antihypertensive medication use 83%). The associations between nighttime home BPs (measured at 2:00, 3:00, and 4:00 am using validated, automatic, and oscillometric home BP devices) and incident CVD, including coronary disease and stroke events, were assessed with Cox proportional hazards models. The mean±SD office, morning home, and nighttime home systolic BP (SBP)/diastolic BP were 140±15/82±10, 137±15/79±10, and 121±15/70±9 mm Hg, respectively. During a follow-up of 7.1±3.8 years (18,116 person-years), 152 CVD events occurred. A 10-mm Hg increase of nighttime home SBP was associated with an increased risk of CVD events (hazard ratios [95% CIs]: 1.201 [1.046-1.378]), after adjustments for covariates including office and morning home SBPs. The model fit assessed by the change in Goodness-of-Fit was improved when we added nighttime home SBP into the base models including office and morning home SBPs (Δ6.838 [5.6%]; P=0.009). This is among the first and largest nationwide practice-based study demonstrating that nighttime SBP obtained using a home device is a predictor of incident CVD events, independent of in-office and morning in-home SBP measurement. Clinical Trial Registration- URL: http://www.umin.ac.jp/icdr/index.html . Unique identifier: UMIN000000894.

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Published In

Hypertension

DOI

EISSN

1524-4563

Publication Date

June 2019

Volume

73

Issue

6

Start / End Page

1240 / 1248

Location

United States

Related Subject Headings

  • Time Factors
  • Systole
  • Prognosis
  • Middle Aged
  • Male
  • Japan
  • Incidence
  • Humans
  • General Practice
  • Follow-Up Studies
 

Citation

APA
Chicago
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MLA
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Kario, K., Kanegae, H., Tomitani, N., Okawara, Y., Fujiwara, T., Yano, Y., & Hoshide, S. (2019). Nighttime Blood Pressure Measured by Home Blood Pressure Monitoring as an Independent Predictor of Cardiovascular Events in General Practice. Hypertension, 73(6), 1240–1248. https://doi.org/10.1161/HYPERTENSIONAHA.118.12740
Kario, Kazuomi, Hiroshi Kanegae, Naoko Tomitani, Yukie Okawara, Takeshi Fujiwara, Yuichiro Yano, and Satoshi Hoshide. “Nighttime Blood Pressure Measured by Home Blood Pressure Monitoring as an Independent Predictor of Cardiovascular Events in General Practice.Hypertension 73, no. 6 (June 2019): 1240–48. https://doi.org/10.1161/HYPERTENSIONAHA.118.12740.
Kario K, Kanegae H, Tomitani N, Okawara Y, Fujiwara T, Yano Y, et al. Nighttime Blood Pressure Measured by Home Blood Pressure Monitoring as an Independent Predictor of Cardiovascular Events in General Practice. Hypertension. 2019 Jun;73(6):1240–8.
Kario, Kazuomi, et al. “Nighttime Blood Pressure Measured by Home Blood Pressure Monitoring as an Independent Predictor of Cardiovascular Events in General Practice.Hypertension, vol. 73, no. 6, June 2019, pp. 1240–48. Pubmed, doi:10.1161/HYPERTENSIONAHA.118.12740.
Kario K, Kanegae H, Tomitani N, Okawara Y, Fujiwara T, Yano Y, Hoshide S. Nighttime Blood Pressure Measured by Home Blood Pressure Monitoring as an Independent Predictor of Cardiovascular Events in General Practice. Hypertension. 2019 Jun;73(6):1240–1248.

Published In

Hypertension

DOI

EISSN

1524-4563

Publication Date

June 2019

Volume

73

Issue

6

Start / End Page

1240 / 1248

Location

United States

Related Subject Headings

  • Time Factors
  • Systole
  • Prognosis
  • Middle Aged
  • Male
  • Japan
  • Incidence
  • Humans
  • General Practice
  • Follow-Up Studies