Device for the self-measurement of blood pressure that can monitor blood pressure during sleep

Chonan, Kenichi; Kikuya, Masahiro; Araki, Tsutomu; Fujiwara, Tohru; Suzuki, Michiko; Michimata, Mari; Hashimoto, Junichiro; Ohkubo, Takayoshi; Hozawa, Atsushi; Yamamoto, N.; Miyawaki, Yutaka; Matsubara, Mitsunobu; Imai, Yutaka

doi:10.1097/00126097-200108000-00008

Cited by 84 publications

(47 citation statements)

References 6 publications

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“…The clinic blood pressure was the average of these two readings. Patients received spoken and written instructions on blood pressure self-measurement and the utilization of the validated 14 oscillometric OMRON HEM-747IC-N monitors (Omron Healthcare). They were asked to measure blood pressure and heart rate after 2 min rest in the sitting position every morning during the whole study.…”

Section: Measurement and Adjustment Of Antihypertensive Treatment Aftmentioning

confidence: 99%

Cardiovascular outcomes in the first trial of antihypertensive therapy guided by self-measured home blood pressure

et al. 2012

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Hypertension guidelines recommend blood pressure self-measurement at home (HBP), but no previous trial has assessed cardiovascular outcomes in hypertensive patients treated according to HBP. The multicenter Hypertension Objective Treatment Based on Measurement by Electrical Devices of Blood Pressure (HOMED-BP;-2010 trial involved 3518 patients (50% women; mean age 59.6 years) with an untreated systolic/diastolic HBP of 135-179/85-119 mm Hg. In a 2 Â 3 design, patients were randomized to usual control (125-134/80-84 mm Hg (UC)) vs. tight control (o125/o80 mm Hg (TC)) of HBP and to initiation of drug treatment with angiotensin converting enzyme inhibitors, angiotensin receptor blockers or calcium channel blockers. During follow-up, a computer algorithm automatically generated treatment recommendations based on HBP. At the last follow-up (median 5.3 years), TC patients used more antihypertensive drugs than UC patients (1.82 vs. 1.74 defined daily doses, P ¼ 0.045) and had a greater HBP reduction (21.3/13.1 mm Hg vs. 22.7/13.9 mm Hg, P ¼ 0.018/0.020), but they less frequently achieved the lower HBP targets (37.4 vs. 63.5%, Po0.0001). The primary end point, cardiovascular death plus stroke and myocardial infarction, occurred in 25 UC and 26 TC patients (hazard ratio, 1.02; 95% confidence interval, 0.59-1.77; P ¼ 0.94). Rates were similar (PX0.13) in the three drug groups. In all patients combined, the risk of the primary end point independently increased by 41% (6-89%; P ¼ 0.019) and 47% (15-87%; P ¼ 0.0020) for a 1-s.d. increase in baseline (12.5 mm Hg) and follow-up (13.2 mm Hg) systolic HBP. The 5-year risk was minimal (p1%) if on-treatment systolic HBP was 131.6 mm Hg or less. HOMED-BP proved the feasibility of adjusting antihypertensive drug treatment based on HBP and suggests that a systolic HBP level of 130 mm Hg should be an achievable and safe target.

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Section: Measurement and Adjustment Of Antihypertensive Treatment Aftmentioning

confidence: 99%

Cardiovascular outcomes in the first trial of antihypertensive therapy guided by self-measured home blood pressure

et al. 2012

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“…The algorisms of both the HBP measuring device and the CBP measuring device have been validated previously (11) and meet the criteria of the Association for the Advancement of Medical Instrumentation (12). (13)(14)(15)(16).…”

Section: Bp Measurementsmentioning

confidence: 99%

Masked Hypertension Determined by Self-Measured Blood Pressure at Home and Chronic Kidney Disease in the Japanese General Population: The Ohasama Study

et al. 2008

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, Takayoshi OHKUBO 4), 5) , Masahiro KIKUYA 6) , Kei ASAYAMA 4), 5) , Ryusuke INOUE 5) , Haruhisa HOSHI 7) , Sadayoshi ITO 1) , and Yutaka IMAI 59.6 mL/min, and 57.3 mL/min for CCr, 4.2%, 8.9%, 10.3%, and 12.8% for the prevalence of positive proteinuria, and 2.3%, 3.0%, 6.3%, and 9.8% for the proportion with CCr <60 mL/min with proteinuria. Compared with the SNBP group, the MHT and SHT groups exhibited significant differences in these parameters (p <0.05, for each). The adjusted odds ratios for CCr <60 mL/min with proteinuria were significantly higher in the MHT (2.56) and SHT (3.60) groups compared with the SNBP group (reference IntroductionAccumulative evidence has revealed that a decreased glomerular filtration rate (GFR) and the presence of proteinuria are independent risk factors for death and/or cardiovascular disease (CVD) events among general populations (1-3). Thus, it is now recognized that chronic kidney disease (CKD) (4) is an emerging new target for investigation from the viewpoint of public health. Hypertension, a classic risk factor for CVD events, can be clinically classified into subgroups: sustained hypertension (SHT), white-coat hypertension (WCHT), and masked hypertension (MHT) (5), which is characterized by normal casual blood pressure (CBP) and elevated home blood pressure (HBP) or ambulatory blood pressure (BP) levels. Among the subtypes, it has been revealed that patients with MHT are at a high risk for CVD morbidity and mortality similar to that of patients with SHT (6, 7). Accordingly, it is clinically important to clarify the relationship between CKD and MHT in terms of screening high-risk populations and targeting therapeutic levels of BP in CKD patients; however, little is known regarding this issue.The present cross-sectional study examined the CKD incidence in subjects with MHT in the Japanese general population. Methods DesignThis study was a part of the Ohasama study, a longitudinal BP measurement project initiated in 1986. The socio-economic and demographic characteristics of this region and full details of the project have been described previously (8). The study was approved by the Institutional Review Board of Tohoku University School of Medicine and the Department of Health of the Ohasama Town Government. Study PopulationIn Japan, annual health checkups are available for farmers, the self-employed, retirees, and dependents aged ≥ 35 years. Among the 7,496 residents of Ohasama, 3,076 were eligible for annual health checkups in 1992. A total of 2,192 residents participated in checkups from 1992 to 1997. Of the 2,192 participants, 215 were excluded due to missing serum creatinine levels, missing dipstick tests for spot-urine, and other confounding factors (age, gender, body mass index [BMI], current smoking, diabetes mellitus, hypercholesterolemia, antihypertensive treatment, and history of CVD). Participants who were hospitalized, mentally ill, or bedridden were also excluded (n= 185). In addition, participants with less than 14 d of HBP measurements and participan...

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“…Recently, home BP-measuring devices capable of monitoring BP during sleep at night have been developed, and their performance has been close or equal to that of ABPM. 7,130,131 Home BP-measuring devices with similar functions to ABPM have also been developed, and the differences between these two methods have been narrowed. 132,133 Generally, the state of sleep is evaluated the next morning according to whether the subject woke up due to operation of the device.…”

Section: Nighttime Bpmentioning

confidence: 99%

“…This is a great advantage of this method. 7 Recently, midnight BP and diurnal changes in BP, as well as morning BP, have become of interest because of their relationships with target organ damage and prognosis. Decreases of 10-20% in nocturnal BP compared with daytime BP are classified as a normal pattern of diurnal changes (dipper), decreases of 0-10% as a nonocturnal-dip type (non-dipper), elevations in BP during the nighttime compared with the daytime as a nocturnal elevation type (riser), and decreases of X20% in nocturnal BP as an excessive decrease type (extreme dipper).…”

Section: Nighttime Bpmentioning

confidence: 99%

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The Japanese Society of Hypertension Guidelines for Self-monitoring of Blood Pressure at Home (Second Edition)

et al. 2012

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INTRODUCTIONSince Riva-Rocci invented indirect brachial cuff sphygmomanometry in 1896 1 and Korotkoff proposed the auscultatory method in 1905, 2 the method for blood pressure (BP) measurements has remained essentially unchanged for the past 100 years.In 1969, Posey et al. 3 identified mean BP on the basis of the cuff-oscillometric method. With subsequent theoretical and technical improvements, the method to determine systolic and diastolic BP (S and D, respectively) was introduced to the cuff-oscillometric method. As a result, many of the automatic electronic sphygmomanometers available today have adopted this method, and those different from the auscultatory method have begun to be used in general clinical practice. Since the advent of indirect methods for sphygmomanometry, the past century has developed the practical and clinical sciences of hypertension. However, BP information necessary for the diagnosis and treatment of hypertension is still obtained essentially on the basis of casual measurements at the outpatient clinic (clinic BP). However, the reliability of clinic BP was called into question 40 years after the advent of indirect sphygmomanometry. In 1940, Ayman and Goldshine 4 widely adopted the concept of self-BP measurements in the field of clinic BP measurements and demonstrated discrepancies between clinic BP and self-BP measurements. Bevan, 5 in the United Kingdom, first reported the results of ambulatory BP (ABP) monitoring (ABPM) using a direct arterial BP measurement method in 1969, and showed that human BP changes markedly with time. The quantity and quality of BP information vary greatly according to different methods, and the problem of interpreting clinic BP, which is obtained specifically in a medical environment, has been an issue in the clinical practice of hypertension during the past 50 years.However, the practice and epidemiology of hypertension still depend entirely on BP information obtained in a medical environment (clinic BP/BP at a health examination), resulting in the

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Device for the self-measurement of blood pressure that can monitor blood pressure during sleep

Cited by 84 publications

References 6 publications

Cardiovascular outcomes in the first trial of antihypertensive therapy guided by self-measured home blood pressure

Cardiovascular outcomes in the first trial of antihypertensive therapy guided by self-measured home blood pressure

Masked Hypertension Determined by Self-Measured Blood Pressure at Home and Chronic Kidney Disease in the Japanese General Population: The Ohasama Study

The Japanese Society of Hypertension Guidelines for Self-monitoring of Blood Pressure at Home (Second Edition)

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