Associations Between Day-by-Day Variability in Blood Pressure Measured at Home and Antihypertensive Drugs: The J-HOME-Morning Study

Ishikura, Kazuki; Obara, Taku; Kato, Taichi; Kikuya, Masahiro; Shibamiya, Taku; Shinki, Takahiro; Ikeda, U; Kobayashi, Yuka; Metoki, Hirohito; Mano, Nariyasu; Kuriyama, Shinichi; Imai, Yutaka

doi:10.3109/10641963.2012.681087

Cited by 31 publications

(18 citation statements)

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“…8,[24][25][26][27][28][29] In addition, various physiological or behavioral factors, including waking and sleep cycles, mental and physical stress, temperature, and alcohol intake can affect both HBPV and VVV. [30][31][32][33][34] Previous studies have shown the factors affecting HBPV, including older age, female gender, high HBP and alcohol intake. 25,[30][31][32] The factors affecting VVV were almost similar to those affecting HBPV in several studies, including older age, female gender, high mean systolic clinic BP and history of myocardial infarction.…”

Section: Discussionmentioning

confidence: 99%

“…[30][31][32][33][34] Previous studies have shown the factors affecting HBPV, including older age, female gender, high HBP and alcohol intake. 25,[30][31][32] The factors affecting VVV were almost similar to those affecting HBPV in several studies, including older age, female gender, high mean systolic clinic BP and history of myocardial infarction. 2,3 In the current study, the male gender was associated with the CV values of CSBP, which is inconsistent with previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…Several previous studies have shown the effects of the classes of antihypertensive drugs on BPV. 32,[39][40][41][42] Many CKD patients receive a combination of several antihypertensive drugs. In the current study, 73% of the patients (n ¼ 105) received two or more antihypertensive drugs which consisted of a combination of a calcium channel blocker and a renin-angiotensin system inhibitor.…”

Section: Discussionmentioning

confidence: 99%

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Association between visit-to-visit clinic blood pressure variability and home blood pressure variability in patients with chronic kidney disease

et al. 2015

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Although both clinic blood pressure (BP) variability and home BP variability are associated with the risk of cardiovascular disease, the relationship between both BP variabilities remain unclear. We evaluated the association between visit-to-visit variability of clinic BP (VVV) and day-by-day home BP variability (HBPV) in patients with chronic kidney disease (CKD). We recruited 143 CKD patients in whom we performed HBP measurements every morning and evening over seven consecutive days. We obtained clinic BP data during 9.6 ± 1.0 consecutive visits within 24 months. The associations between the variables of VVV and HPBV were examined. In conclusion, VVV showed a weak but significant association with HBPV, especially the CV values of ESBP in CKD patients. Further studies are necessary to clarify whether these different BPV elements will be alternative marker of BPV.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Association between visit-to-visit clinic blood pressure variability and home blood pressure variability in patients with chronic kidney disease

et al. 2015

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“…Some studies obtained home BP readings and used the SD or coefficient of variation of morning BP [28], or SD of daily mean or daily morning or evening BP [13,29]. Some studies obtained home BP readings and used the SD or coefficient of variation of morning BP [28], or SD of daily mean or daily morning or evening BP [13,29].…”

Section: Indices To Evaluate Drug Effects On Blood Pressure Variabilitymentioning

confidence: 99%

Assessment of drug effects on blood pressure variability

Stergiou

Ntineri

2014

Journal of Hypertension

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B lood pressure (BP) is known to be a continuous variable with dynamic characteristics of variability in response to daily physical and mental stimuli. The idea that the variation of BP puts additional burden on the heart and vasculature beyond that of average BP has been regarded for decades as a reasonable concept by researchers, practitioners and even patients. However, in contrast to the straightforward approach required for the evaluation of average BP, the quantification of the BP variability (BPV) turned out to be a tricky task. Interestingly, several different lines of evidence suggest that the BPV has independent prognostic value beyond that of average BP. However, to date the plethora of methodological approaches applied in different studies and the lack of evidence on critical relevant research issues did not allow BPV to be used in practice as a tool for improving the management of hypertensive patients.For the quantification of BPV, several measurement methods and sampling of BP readings have been used, and several mathematical approaches have been applied (Tables 1-2The different methods available for office and out-ofoffice BP measurement have been used to provide information on different aspects of BPV. Evaluation of BPV using each of these methods has been shown to independently predict cardiovascular risk [1-3,11-17]. However, each BPV component seems to reflect different mechanisms, is likely to provide different information on cardiovascular regulation and might have different clinical implications [12,18].Very-short-term BPV can be assessed by continuous beat-to-beat intraarterial BP monitoring or noninvasive finger-cuff photoplethysmography. The use of the former is limited because of the invasive nature and the latter because of questionable measurement accuracy.Short-term BPV is based on intermittent BP sampling at 15-30-min intervals in a routine 24-h period, obtained using noninvasive oscillometric ambulatory monitors. This appears to be an ideal method for routine BPV evaluation, by providing information on the dispersion of BP values in different conditions of posture and activity. However, the independent prognostic value of ambulatory BPV has been questioned, and its application might not be well accepted by patients for repeated use in the long-term management of hypertension. In the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT), ambulatory BPV had less effect on vascular events than that assessed by office measurements [2]. Moreover, analysis of the International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcome (IDACO) showed that the 24-h ambulatory BPV did not contribute much to risk stratification over and beyond the average ambulatory BP [15]. It should be mentioned, however, that most of the published studies have been limited by infrequent ambulatory BP sampling, whereas it has been shown that measurements at 15-min intervals are required to provide an accurate assessment of BPV [19].Mid-term day-by-day BPV based on self-home BP monitoring has a...

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“…Although the 24-hour ambulatory monitoring of blood pressure represents the gold standard for the diagnosis and evaluation of treatment response in hypertension, home blood pressure measurement is widely available and well tolerated by the patient [2,3]. Accumulating evidence reveals that an increase in 24-hour blood pressure variability as well as in home blood pressure variability is associated with end-organ damage [4][5][6][7]. The self-measurement of blood pressure at home offers the possibility for a long-term monitoring of the blood pressure variability and removes the whitecoat phenomenon.…”

Section: Introductionmentioning

confidence: 99%

The Importance of Home Versus 24-Hour Ambulatory Blood Pressure Monitoring and Assessment of Blood Pressure Variability in Hypertension

Magdás

Belényi

Găburoi

et al. 2016

Acta Medica Marisiensis

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Background: A number of studies reveal that home blood pressure variability is associated with cardiovascular risk factors. However, we do not have a consensus regarding the variability index and the frequency of measurements. Objective: The aim of the study was to assess home blood pressure variability for a period of 7 consecutive days and 24-hour ambulatory blood pressure variability using the average real variability index and to test whether home blood pressure variability represents a suitable parameter for long-term monitoring of the hypertensive patients. Material and methods: A number of 31 hypertensive patients were included in the study, 8 male, 23 female, mean age 60.19±7.35 years. At the inclusion ambulatory blood pressure monitoring was performed, home blood pressure monitoring was carried out for 7 consecutive days with 2 measurements daily. We compared ambulatory blood pressure values, variability using paired t-test. We were looking for correlations between HBP values and cardiovascular risk factors. Results: Ambulatory versus home blood pressure derived mean blood pressure was 131.38±15.2 versus 131.93±8.25, p=0.81. Ambulatory derived variability was 10.65±2.05 versus home variability 10.56±4.83, p=0.91. Home versus ambulatory pulse pressure was 51.8± 9.06 mmHg vs. 54.9±11.9 mmHg, p=0.046. We found positive correlation between HBPV and home BP values, p=0.027, r2=0.1577, (CI: 0.04967 to 0.6588). Home, as well as ambulatory derived variability were positively correlated to age p=0.043, r2=0.1377 (CI: 0.01234 to 0.6451) versus p<0.0001, CI: 0.3870 to 0.8220, r2=0.4302. Conclusion: Assessment of home blood pressure monitoring and variability could represent a well-tolerated alternative for long-term follow-up of hypertension management.

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Associations Between Day-by-Day Variability in Blood Pressure Measured at Home and Antihypertensive Drugs: The J-HOME-Morning Study

Cited by 31 publications

References 29 publications

Association between visit-to-visit clinic blood pressure variability and home blood pressure variability in patients with chronic kidney disease

Association between visit-to-visit clinic blood pressure variability and home blood pressure variability in patients with chronic kidney disease

Assessment of drug effects on blood pressure variability

The Importance of Home Versus 24-Hour Ambulatory Blood Pressure Monitoring and Assessment of Blood Pressure Variability in Hypertension

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