Clinical Signicance of Blood Pressure Response Triggered by a Doctor's Visit in Patients with Essential Hypertension.

Munakata, Masanori; Saito, Yuki; Nunokawa, Tohru; Ito, Nobuhiko; Fukudo, Shin; Yoshinaga, Kaoru

doi:10.1291/hypres.25.343

Cited by 23 publications

(15 citation statements)

References 18 publications

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“…First, we adopted only one value measured within 1 month before or after the period of home blood pressure measurement as casual blood pressure, since almost subjects were healthy normotensives. Therefore, the influence of the white-coat effect may have been strong (22), and there is a possibility that some whitecoat hypertensives were included in the nontreated hypertensive group. Second, we took three home blood pressure measurements on each occasion in this study.…”

Section: Discussionmentioning

confidence: 99%

Status of Home Blood Pressure Measured in Morning and Evening: Evaluation in Normotensives and Hypertensives in Japanese Urban Population

2005

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To assess home blood pressure status in a Japanese urban population, we analyzed home blood pressure values in normotensive subjects determined by casual blood pressure (<140/90 mmHg), hypertensive subjects without medication (≥140/90 mmHg) and treated hypertensive patients. The subjects (468 male, 232 female; mean age 41 years old) were recruited from a company located in Tokyo. Home blood pressure was measured with a semi-automatic device (Omron HEM-759P). Subjects were instructed to perform triplicate morning and evening measurements on 7 consecutive days. In the treated hypertensive group (n =70), there was a significant difference between morning (139 ± 12/88 ± 9 mmHg) and evening (130 ± 12/79 ± 8 mmHg) home blood pressure. In the normotensive group (n =558), however, only the diastolic blood pressure (DBP) component of the home blood pressure was significantly different between morning (115 ± 13/72 ± 9 mmHg) and evening (114 ± 12/68 ± 8 mmHg). In the nontreated hypertensive group (n =72), casual blood pressure (145±14/92 ± 9 mmHg) was higher than morning (138 ± 16/89 ± 11 mmHg) and evening (134 ± 16/83 ± 11 mmHg) home blood pressure, but no difference was seen between morning and evening systolic blood pressure (SBP). According to the reference value of the Japanese Society of Hypertension 2004 (SBP ≥135 mmHg and/or DBP ≥85 mmHg), 7.2% (systolic) and 8.7% (diastolic) of subjects in the normotensive group were classified as hypertensive by home blood pressure. Casual blood pressure in the treated hypertensive group was normal in 64.3% for SBP and 70.0% for DBP. However, their morning SBP (32.9%), morning DBP (40.0%), evening SBP (10.0%), and evening DBP (17.1%) were classified as hypertensive by home blood pressure. Furthermore, patients who were taking antihypertensive drug(s) only in the morning (n =52) showed higher morning SBP (6 mmHg, p =0.086) and morning DBP (6 mmHg, p =0.005) than patients taking drug(s) by other administration schedules (n =18), but no difference in evening home blood pressure was observed. In conclusion, a proportion of the subjects defined as normotensive by casual blood pressure Hypertens Res Vol. 28, No. 6 (2005) IntroductionSelf-measurement of blood pressure at home has developed enormously in recent years (1) and is useful in raising people's concern about hypertension. In the medical management of hypertensive patients, home blood pressure measurement raises their knowledge and consciousness of hypertension, and has become one of the important means of motivating patients to take an active, positive role in their medical treatment. However, there have been few reports on the status of home blood pressure values in normotensives and hypertensive patients (2, 3).It has been reported that only a small proportion of patients on antihypertensive drugs have well controlled blood pressure (4−6). It has also been suggested that this apparently poor blood pressure control is caused, at least in part, by the so-called "white-coat effect," since casual blood pressure taken in medi...

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Section: Discussionmentioning

confidence: 99%

Status of Home Blood Pressure Measured in Morning and Evening: Evaluation in Normotensives and Hypertensives in Japanese Urban Population

2005

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“…Although Lantelme et al (22) found a weak correlation between the two WCE measures (r= 0.31, p= 0.004), Palatini et al found none (26). Munakata et al found that the true WCE, measured with a Finapres device, correlated with left ventricular mass index in men, but not in women (27), but Lantelme et al (22) found no relationship in either sex. Palatini et al (26) found a significant correlation between the true WCE and the blood pressure response to a speech task (r= 0.50, p< 0.001).…”

Section: Reduced Clinic Pressurementioning

confidence: 98%

Masked Hypertension: A Review

2007

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“…Another possible explanation is a gender difference in pressor response to psychological stress. We have previously reported in untreated hypertensive patients that men showed a significantly greater blood pressure increase in response to experimental psychological stress than did women 13) . Our study has several limitations.…”

Section: Discussionmentioning

confidence: 79%

Skill Underutilization is Associated with Higher Prevalence of Hypertension: The Watari Study

Konno

Munakata

2014

Journal of Occupational Health

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Skill Underutilization is Associated with Higher Prevalence of Hypertension: the Watari Study: Satoshi KONNO, et al. Preventive Medical Center and Division of Hypertension, Tohoku Rosai Hospital— Objectives The aim of this study was to investigate the association between skill underutilization, a psychological job stressor proposed in the NIOSH (National Institute for Occupational Safety and Health) job stress model, and the prevalence of hypertension. Methods We studied sitting blood pressure and fasting blood laboratory parameters in 3,429 inhabitants of the town of Watari during annual health check‐ups in 2010. A questionnaire was administered to examine job status, weekly working hours and degree of skill utilization. We divided subjects into tertiles according to skill utilization score. Multivariate logistic regression analysis was performed using prevalent hypertension as the dependent variable. Results Questionnaires were collected from 2,550 individuals. After excluding those who were not in paid employment and those with missing data, 1,075 permanent or part‐time workers were included in the final analysis. The odds ratio for the presence of hypertension was significantly higher in the lowest tertile of skill utilization score compared with the highest tertile (1.776; 95% confidence interval, 1.137−2.796) after adjusting for age, sex, body mass index, low‐density lipoprotein cholesterol level, triglyceride level, current smoking status and daily alcohol intake. Conclusions Skill underutilization was associated with a higher prevalence of hypertension in a working population including various kinds of occupations.

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Clinical Signicance of Blood Pressure Response Triggered by a Doctor's Visit in Patients with Essential Hypertension.

Cited by 23 publications

References 18 publications

Status of Home Blood Pressure Measured in Morning and Evening: Evaluation in Normotensives and Hypertensives in Japanese Urban Population

Status of Home Blood Pressure Measured in Morning and Evening: Evaluation in Normotensives and Hypertensives in Japanese Urban Population

Masked Hypertension: A Review

Skill Underutilization is Associated with Higher Prevalence of Hypertension: The Watari Study

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