Objective:Few studies have investigated weekly variations in long-term home blood pressure (BP) measurement. The aim of this study was to examine the intra-week variability and the difference in the day of the week on long-term home BP with or without antihypertensive medication.Design and method:This study was based on an ongoing community-based intervention study in Nose, Osaka, which was designed to assess the effect of home BP measurement on prolonging healthy life expectancy. The study included 510 participants aged 40–91 years. Participants measured their BP with an electronic oscillometric device (HEM-7281; Omron Healthcare CO., Ltd) and wrote the value on the recording book twice in morning and evening for about six months to a year. The intra-week variability in home BP were calculated as maximum minus minimum BP (MMD: maximum-minimum difference). Home BP recording for 62916 days were obtained by extracting weeks in which BP were measured on 7 consecutive days. The participants were divided into 2 groups according to with or without antihypertensive medication. The mean BP values according to the day of the week of home BP measurement were compared by one-way analysis of variance. MMD means were compared with the t-test. To identify the factors influencing on the intra-week variability in home BP, Multiple linear regression models were applied to examine.Results:Among participants without antihypertensive medication, morning systolic BP(SBP) was lowest on Saturday (p < 0.001) as compared with all other days of the week and evening SBP tends to be highest on Sunday. Among participants with antihypertensive medication, morning SBP tends to be lowest on Saturday and evening SBP was highest on Sunday (p < 0.001). The characteristics of the day of the week were similar for the two groups. Antihypertensive medication was not significantly associated with MMD in morning SBP in the multiple linear regression model. MMD in morning SBP had significant positive relationships with female(β = 0.05) and age(β = 0.07), measurement in winter(β = 0.04), morning SBP means(β = 0.25), respectively by p < 0.001.Conclusions:Evening SBP was highest on Sunday regardless of antihypertensive medication. This may be related with clinical evidence that cardiovascular events occur more frequently in the morning on Monday. Considering a variety of factors associated with the intra-week variability in home BP with or without antihypertensive medication, this observation suggested that treatment decisions against hypertension may be based on long-term home BP measurements.

s e339the medication coverage by ~40% and could substantially enhance the effects of the other reforms when combined (e.g., Figure ). The combination of only SPC and 3-month prescription can almost triple the number of patients able to receive antihypertensive medication. Conclusion:In India , s public health care system, without additional costs to the health system, three reforms (increasing SPC use, restricting the number of medication types, and extending prescription periods) could substantially increase the number of patients to receive hypertension medications. Our study encourages the combination of these reforms to improve hypertension management coverage in India.

Aim:The May Measurement Month (MMM) programme is a global cross-sectional blood pressure (BP) screening programme. Here we present the combined data for the years 2017, 2018 and 2019 from Vietnam.Study methods: BP was measured at various screening sites, according to MMM standard protocol and hypertension was diagnosed if the BP was equal or over 140/90 mmHg or if the individual was already on antihypertensive medication.

Preventing illness and promoting health is important for prolonging healthy life expectancy, and it also leads to the reduction of medical and long-term care costs. As Japan has entered a super-aged society, prevention of CVD, which causes stroke and dementia, the main causative diseases of the need for long-term care, is becoming more important. In addition, it is necessary to widely implement these CVD prevention strategy from an early stage. In other words, not only the tertiary preventive measures after the onset, but also the secondary preventive measures that extract high-risk populations and the primary preventive measures that approach the entire community are required.Under these circumstances, the specific health checkup and specific health guidance system was started in 2008 in Japan. This system has a new concept in which medical insurers take the lead in implementing it, and aims to prevent the onset of illness by providing lifestyle modification support to people at high risk of metabolic syndrome. This system has been established nationwide and has been successful. On the other hand, there are not a few people who leave medical treatment of lifestyle-related diseases, discontinued treatment, or even have not received medical checkup, which is an urgent issue. It is expected that various medical professionals will provide health guidance for those undergoing treatment, encourage continuous treatment, support for improving adherence, along with the nationwide health promotion such as increasing the rate of people taking health checkup or improvement of healthy environment in the community and workplace.The extension of healthy life expectancy for the entire nation will be realized by strengthening of cooperation between preventive intervention and medical care by various medical professionals. In the session, we will outline the current status of multidisciplinary collaboration efforts of health professionals in community, and introduce the examples of RCT results of nurse-led alcohol guidance effects in hypertensive outpatient clinics that we have conducted.

Objective:To determine the association between skeletal muscle mass and systolic blood pressure decline over a 5-year period in older adults over 75 years old.Methods:Of those who got health checkups at private A clinic from May 2020 to March 2021, 118 subjects for whom data on systolic blood pressure (SBP) levels consequently collected for five years were included. Skeletal muscle mass was measured at the health checkup in this clinic, and the Skeletal Muscle Index (SMI) was calculated by dividing the sum of limb muscle mass by the square of height using the multi-frequency bioimpedance method. Lower SMI was classified as a relative skeletal muscle mass index less than 7.0 kg/m2 and 5.7 kg/m2 in men and women, respectively. SBP levels used the mean of office SBP at A clinic visits in 2020 and 2015. 5-year SBP changes were calculated and categorized into two groups: SBP decline group (decline of -3 or more) and SBP maintenance group. The main outcome was SBP decline, and the association with SMI was examined by chi-square test and logistic regression analysis adjusted for age and gender.Results:The mean age of the subjects was 81.1 ± 4.5 years, 76 (64.4%) were female, 76(64.4%) were taking anti-hypertensive medication, 40(33.9%) were lower SMI, and 39 (33.1%) for SBP decline group. The SBP decline group had a lower BMI and a higher percentage of lower SMI than the maintenance group (p < 0.05). Furthermore, logistic regression analysis showed that lower SMI was independently associated with SBP decline (odds ratio: 2.44, 95% CI: 1.07–5.54).Conclusion:Our results suggest that there may be an association between lower SMI and SBP decline over a 5-year period in community-dwelling older adults over 75 years old. Long term changes of SBP might be the useful biomarker for muscle mass decline for older adults, although further mechanistic investigations are necessary.