Difference between Home and Office Blood Pressures among Treated Hypertensive Patients from the Japan Home versus Office Blood Pressure Measurement Evaluation (J-HOME) Study

When interpreting home blood pressure (BP) measurements in hypertensive patients, differences between clinic and home BP should be noted. To investigate the differences between clinic and morning home BP in hypertensive patients, we analyzed clinic systolic BP (CSBP) and morning home systolic BP (MHSBP) data from the large-scale observational HONEST (Home BP measurement with Olmesartan Naive patients to Establish Standard Target blood pressure) study (n=21 340), using BP measurements obtained before starting olmesartan administration. We generated Bland–Altman plots, with the horizontal axis representing mean CSBP and MHSBP ([CSBP+MHSBP]/2) and the vertical axis representing the difference between CSBP and MHSBP (CSBP–MHSBP). We also did simulation experiments to explore factors affecting the results of the Bland–Altman plots. The difference between CSBP and MHSBP increased as the mean of the two values increased, and when the mean of CSBP and MHSBP was close to 140 mm Hg, the difference was theoretically 0 in average, although large interindividual BP variability existed in this BP range. Results were unaffected by factors such as previous antihypertensive treatment, age and concomitant diabetes or chronic kidney disease. Bland–Altman plots generated from simulated data of normal distribution showed that the slope of the regression line sloped upward, consistent with the results of the HONEST study, when the interindividual BP variability of MHSBP was less than that of CSBP. In conclusion, differences between mean CSBP and MHSBP may be caused by large interindividual variability in CSBP. Therefore, the differences between MHSBP and CSBP may vary between patient groups, which should be noted in the management of hypertension.

show abstract

“…In addition, the results of the J-HOME study showed that the difference between CSBP and MHSBP is increased in older patients. 25 …”

Section: Discussionmentioning

confidence: 99%

Differences between clinic blood pressure and morning home blood pressure, as shown by Bland–Altman plots, in a large observational study (HONEST study)

et al. 2015

View full text Add to dashboard Cite

show abstract

“…[7][8][9][10] Masked hypertension is prevalent in CKD patients, 13,14 and older age is associated with a greater prevalence of masked hypertension among treated hypertensive patients. 15,16 Thus, HBP measurement might contribute to improved BP control in elderly CKD patients.…”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of home blood pressure control on renal and cardiovascular outcomes in elderly patients with chronic kidney disease

et al. 2009

View full text Add to dashboard Cite

The influence of home blood pressure (HBP) control on renal and cardiovascular outcomes is not fully defined, and the optimal blood pressure (BP) target in elderly patients with chronic kidney disease (CKD) remains unknown. To clarify the influence of HBP on the progression of CKD and the occurrence of cardiovascular events in elderly CKD patients, we recruited 104 patients with stage 3 to 5 CKD, who were X70 years of age. The mean follow-up duration was 39±15 months. HBP was measured every morning and evening for 7 consecutive days. HBP data were obtained every 6 months for 79 of these patients. There were significant correlations observed between morning systolic BP (SBP), evening SBP and the change in estimated glomerular filtration rate (eGFR) during the follow-up period (baseline/follow-up; morning r¼À0.55/À0.51, evening r¼À0.48/À0.38, all Po0.0001, baseline: baseline values, follow-up: mean values obtained every 6 months during the follow-up period). Stepwise multivariate regression analysis identified morning SBP and urinary protein excretion as independent predictors of a change in eGFR during the follow-up period. Cox proportional hazards analysis showed that baseline morning SBP, baseline evening SBP and follow-up morning SBP were significantly associated with an increased risk of renal events (hazard ratios; 1.04 (95% CI, 1.01-1.07), 1.06 (1.02-1.09) and 1.10 (1.04-1.17), respectively). However, Cox proportional hazards analyses showed that there was no significant association between BP and the risk of cardiovascular events. In conclusion, even among elderly CKD patients, HBP is a significant predictor of decline in renal function and the development of end-stage renal disease. In addition, the optimal target BP for elderly CKD patients needs to be clarified.

show abstract

“…Educational factor, e.g., years of schooling and academic degrees attained, were proven by Liu et al and Sun et al to be inversely associated with BP [32,33], most likely related to personal awareness and healthy lifestyle [34]. Diabetes and insulin resistance, through means of recently uncovered mech- [40,41].…”

Section: Discussionmentioning

confidence: 99%

Hypertension phenotypes in rural part of East Indonesia: the TENSI pilot study

Nugroho

Masrika

2023

Arterial Hypertension

View full text Add to dashboard Cite

Background: Though extensively studied in other Asian countries, office and home blood pressure (BP)-based hypertension determination and phenotypes in rural population are still scarcely investigated in Indonesia. We aim to elaborate this in an East Indonesia rural area, by implementing two available BP thresholds. Material and methods: The Ternate Sehat Indonesia (TENSI) pilot study obtained demographic, anthropometric, biochemistry, office and home BP data from 146 residents aged ≥ 18 years old living in Ternate Island from July-August 2022. Hypertension and its phenotypes were defined in accordance with the 2019 Indonesian Society of Hypertension (InaSH) and the 2017 American College of Cardiology/American Heart Association (ACC/AHA) BP guidelines. Office and home BP differences were analyzed within each participant's characteristics. Results: Mean mm Hg ± SD office and home (i) systolic BP were 121.8 ± 17.9 and 117.8 ± 14.8 mm Hg (p < 0.001), (ii) diastolic BP were 77.9 ± 12.1 and 74.7 ± 8.9 mm Hg (p < 0.001). Hypertension was evident in 26% (InaSH) and 34.2% (ACC/AHA) participants. Moreover, 17.4% (InaSH) and 24.8% (ACC/AHA) of those self-reported to not having hypertension were found to be hypertensives. The proportion of sustained, white-coat, and masked hypertension were 7.5%, 9.6%, 8.9% (InaSH), and 8.2%, 21.2%, 4.8% (ACC/AHA). Compared to office BP, home BP significantly differed throughout more characteristics. Conclusions: Our study has ascertained the actual hypertension status and phenotypes within a rural East Indonesia environment. The revelation of stronger home BP ability to detect BP differences may promote its application within the population in the future.

show abstract

Difference between Home and Office Blood Pressures among Treated Hypertensive Patients from the Japan Home versus Office Blood Pressure Measurement Evaluation (J-HOME) Study

Cited by 16 publications

References 29 publications

Differences between clinic blood pressure and morning home blood pressure, as shown by Bland–Altman plots, in a large observational study (HONEST study)

Differences between clinic blood pressure and morning home blood pressure, as shown by Bland–Altman plots, in a large observational study (HONEST study)

Prognostic significance of home blood pressure control on renal and cardiovascular outcomes in elderly patients with chronic kidney disease

Hypertension phenotypes in rural part of East Indonesia: the TENSI pilot study

Contact Info

Product

Resources

About