How many times should blood pressure be measured at home for better prediction of stroke risk? Ten-year follow-up results from the Ohasama study

Ohkubo, Takayoshi; Asayama, Kei; Kikuya, Masahiro; Metoki, Hirohito; Hoshi, Hiroyuki; Hashimoto, Junichiro; Totsune, Kazuhito; Satoh, Hiroshi; Imai, Yutaka; Study, Ohasama

doi:10.1097/00004872-200406000-00009

Cited by 241 publications

(176 citation statements)

References 21 publications

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“…Sole reliance on clinic or office readings may result in misclassification of patients, either hypertensive or normotensive, in upto 69% of cases. 49 Ohkubo et al 50 have indicated that even one self-measurement in the morning is more predictive of stroke than OBP, but the predictive precision improves as the number of readings increases. There remains significant debate on the frequency and mode of operation for SBPM.…”

Section: Discussionmentioning

confidence: 99%

Self blood pressure monitoring: a worthy substitute for ambulatory blood pressure?

McGowan

Padfield

2010

J Hum Hypertens

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lines for self-monitoring of blood pressure (SBPM). We aimed to demonstrate the equivalence of SBPM with ambulatory blood pressure monitoring (ABPM) in the assessment of hypertension. A total of 87 consecutive subjects referred from primary care for standard ABPM underwent a 1-week period of SBPM, as defined by the ESH guidelines, either before or after ABPM. There was no difference in mean blood pressure (BP): SBPM 142/ 87 mm Hg, daytime average ABPM 141/86 mm Hg. The intra-class correlation coefficient was 0.72 and 0.89 for systolic and diastolic pressure, respectively. SBPM is concordant with ABPM in classifying subjects as hypertensive or normotensive in 87% of cases (j ¼ 0.56). The coefficient of variation of SBPM compared with ABPM was 5%. In answer to a direct question 81% of subjects preferred SBPM to ABPM. The current self-monitoring schedule recommended by the ESH, AHA and ASH is valid. The mean BP obtained from SBPM is equivalent to awake-time BP on ABPM, the accepted reference standard for 'out of office' BP measurement. SBPM is simpler to carry out, preferred by patients and should be considered on a par with ABPM.

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Section: Discussionmentioning

confidence: 99%

Self blood pressure monitoring: a worthy substitute for ambulatory blood pressure?

McGowan

Padfield

2010

J Hum Hypertens

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“…The high prognostic significance of home BP is considered to be derived from the stability of BP information. [33][34][35][36][37][38][39][40][41] Evidence has also shown that home BP reflects target organ damage with similar or higher reliability than ABP. [42][43][44][45][46] ABPM provides data on short-term BP variability every 15-30 min, and these values are reported to have prognostic significance.…”

Section: ) Home Bp and Prognosismentioning

confidence: 99%

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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“…1,2 Previous reports have shown that CBP, as measured in strict accordance with the procedures set forth in the guidelines, had a clinical value at least comparable with BP measured in out-of-clinical settings, 3 although BP measured in out-of-clinical settings has several advantages, including the avoidance of both observer bias and the white-coat effect. 4,5 Therefore, in clinical trials and epidemiological surveys, CBP has often been measured in accordance with the procedures outlined in the guidelines. However, in actual clinical settings, CBP may rarely be measured in accordance with the guidelines and the accuracy of CBP measurement may be ignored.…”

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confidence: 99%

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confidence: 99%

Practice and awareness of physicians regarding casual-clinic blood pressure measurement in Japan

et al. 2010

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The optimal procedure for casual-clinic blood pressure (CBP) measurement is outlined in the 2004 Japanese guidelines. We investigated the status of physicians' practices and their awareness of CBP measurement immediately and 4 years after the publication of the guidelines using a questionnaire regarding CBP. This survey was conducted among physicians who attended educational seminars on hypertension in 2004-2005 and in 2007-2008; the questionnaire was distributed, completed and collected just before the start of the seminars. Of the 1966 respondents to the 2004-2005 survey and the 2995 respondents to the 2007-2008 survey, the proportion of physicians who answered that CBP was more important than self-measured BP at home (home BP) was less than 10% in both surveys. The proportion of physicians who used a mercury sphygmomanometer (68.1-75.5%) was higher than those who used an automatic and electronic sphygmomanometer (20.7-29.0%) in both surveys. However, the use of an automatic and electronic sphygmomanometer slightly increased from 20. Keywords: casual-clinic blood pressure; guidelines; physicians INTRODUCTION Blood pressure (BP) is a major vital sign used to evaluate the physical condition of each patient. Measurement of casual-clinic BP (CBP) in clinical settings has been used as the gold standard for hypertension evaluation. Under the Japanese guidelines for the management of hypertension, the optimum conditions for CBP measurement include the use of the auscultation method, with a mercury or aneroid sphygmomanometer for the measurement of CBP, or the use of an automatic sphygmomanometer that has been calibrated. 1,2 Previous reports have shown that CBP, as measured in strict accordance with the procedures set forth in the guidelines, had a clinical value at least comparable with BP measured in out-of-clinical settings, 3 although BP measured in out-of-clinical settings has several advantages, including the avoidance of both observer bias and the white-coat effect. 4,5 Therefore, in clinical trials and epidemiological surveys, CBP has often

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How many times should blood pressure be measured at home for better prediction of stroke risk? Ten-year follow-up results from the Ohasama study

Cited by 241 publications

References 21 publications

Self blood pressure monitoring: a worthy substitute for ambulatory blood pressure?

Self blood pressure monitoring: a worthy substitute for ambulatory blood pressure?

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

Practice and awareness of physicians regarding casual-clinic blood pressure measurement in Japan

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