Expert panel consensus recommendations for home blood pressure monitoring in Asia: the Hope Asia Network

J of Clinical Hypertension

Tomitani

Buranakitjaroen

et al. 2018

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A self‐measured home blood pressure (BP)‐guided strategy is an effective practical approach to hypertension management. The Asia BP@Home study is the first designed to investigate current home BP control status in different Asian countries/regions using standardized home BP measurements taken with the same validated home BP monitoring device with data memory. We enrolled 1443 medicated hypertensive patients from 15 Asian specialist centers in 11 countries/regions between April 2017 and March 2018. BP was relatively well controlled in 68.2% of patients using a morning home systolic BP (SBP) cutoff of <135 mm Hg, and in 55.1% of patients using a clinic SBP cutoff of <140 mm Hg. When cutoff values were changed to the 2017 AHA/ACC threshold (SBP <130 mm Hg), 53.6% of patients were well controlled for morning home SBP. Using clinic 140 mm Hg and morning home 135 mm Hg SBP thresholds, the proportion of patients with well‐controlled hypertension (46%) was higher than for uncontrolled sustained (22%), white‐coat (23%), and masked uncontrolled (9%) hypertension, with significant country/regional differences. Home BP variability in Asian countries was high, and varied by country/region. In conclusion, the Asia BP@Home study demonstrated that home BP is relatively well controlled at hypertension specialist centers in Asia. However, almost half of patients remain uncontrolled for morning BP according to new guidelines, with significant country/regional differences. Strict home BP control should be beneficial in Asian populations. The findings of this study are important to facilitate development of health policies focused on reducing cardiovascular complications in Asia.

Section: Introductionmentioning

confidence: 99%

Home blood pressure control status in 2017‐2018 for hypertension specialist centers in Asia: Results of the Asia BP@Home study

J of Clinical Hypertension

Tomitani

Buranakitjaroen

et al. 2018

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“…Morning BP measurements should be taken within 1 hour of waking, after urination, before breakfast, and prior to taking any antihypertensive medication. Evening BP measurements should be taken before going to bed . Patients need to take at least 2 BP readings each time, with a 1‐minute interval between measurements .…”

Section: How and When Should Home Bp Be Measured?mentioning

confidence: 99%

“…The Hypertension Cardiovascular Outcome Prevention and Evidence (HOPE) Asia Network, recently studied the current evidence of HBPM and developed a set of expert panel consensus recommendations for HBPM in Asia . Here, we provide the key messages and practice points (Figure ) that can be easily implemented in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Guidance on home blood pressure monitoring: A statement of the HOPE Asia Network

J of Clinical Hypertension

Park

Buranakitjaroen

et al. 2018

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Hypertension is an important modifiable cardiovascular risk factor and a leading cause of death throughout Asia. Effective prevention and control of hypertension in the region remain a significant challenge despite the availability of several regional and international guidelines. Out‐of‐office measurement of blood pressure (BP), including home BP monitoring (HBPM), is an important hypertension management tool. Home BP is better than office BP for predicting cardiovascular risk and HBPM should be considered for all patients with office BP ≥ 130/85 mm Hg. It is important that HBPM is undertaken using a validated device and patients are educated about how to perform HBPM correctly. During antihypertensive therapy, monitoring of home BP control and variability is essential, especially in the morning. This is because HBPM can facilitate the choice of individualized optimal therapy. The evidence and practice points in this document are based on the Hypertension Cardiovascular Outcome Prevention and Evidence (HOPE) Asia Network expert panel consensus recommendations for HBPM in Asia.

“…[27][28][29][30] We stressed the importance of morning home BP in clinical practice [27][28][29][30] because morning home BP has shown better reproducibility than evening home BP or clinic BP. 36 However, the measurement of evening home BP just before going to bed is strongly affected by the individual's dinner (including alcohol consumption) and evening behavior (eg, bathing in the evening is common in Asia).…”

Section: Facilitation Of a Home Bp-guided Approach In Asiamentioning

confidence: 99%

“…Specifically, we have focused on a morning home BP-guided approach as the most effective strategy to achieve zero cardiovascular events in Asia. [27][28][29][30] The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2014) first documented a home BP-guided approach as the most effective practical approach in clinical practice. 31 The 2017 ACC/AHA guidelines recommended home BP monitoring for confirmation of the diagnosis of hypertension and for titration of BP-lowering medication, in conjunction with telehealth counseling (recommendation: Class I; Level of Evidence A).…”

Section: Facilitation Of a Home Bp-guided Approach In Asiamentioning

confidence: 99%

Could 130/80 mm Hg Be Adopted as the Diagnostic Threshold and Management Goal of Hypertension in Consideration of the Characteristics of Asian Populations?

Wang

2018

Hypertension

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