Association of Morning and Evening Blood Pressure at Home With Asymptomatic Organ Damage in the J-HOP Study

Hoshide, Satoshi; Yano, Yuichiro; Haimoto, Hajime; Yamagiwa, Kayo; Uchiba, Kiyoshi; Nagasaka, Shoichiro; Matsui, Yoshio; Nakamura, Akira; Fukutomi, Motoki; Eguchi, Kazuo; Ishikawa, Joji

doi:10.1093/ajh/hpt290

Cited by 71 publications

(62 citation statements)

References 37 publications

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“…2,12,13 Second, morning BP is more reflective of certain pathophysiological conditions compared with evening BP, such as obesity, sleep apnea, and various target-organ damages (eg, left ventricular hypertrophy, albuminuria, and vascular dysfunction). 19,25,26 However, in our study, the association of morning SBP with stroke risk was independent of organ damage markers (ie, microalbuminuria and brain natriuretic peptide values). This suggests that higher morning SBP may not be merely an epiphenomenon of comorbidities, but causally related to stroke occurrence.…”

Section: Discussioncontrasting

confidence: 72%

“…The Japan Morning Surge-Home Blood Pressure (J-HOP) study 19 is a prospective observational study (University Hospital Medical Information Network Clinical Trials Registry, UMIN000000894) of 4310 patients with a history of or risk factors for CVD, or both, who were recruited between 2005 and 2012 and followed up through March 2015 by 75 doctors at 71 institutions (45 primary practices, 22 hospital-based outpatient clinics, and 4 specialized university hospitals; see online-only Data Supplement). Details of the study design and methods are described in the online-only Data Supplement.…”

Section: Methodsmentioning

confidence: 99%

“…This protocol provided several advantages over the prior home BP studies (Table S1 in the online-only Data Supplement). [4][5][6][7][8][9][10] First, the office and home BP were measured using the same validated, automatic, and oscillometric device (HEM-5001; Omron Healthcare Co., Ltd.) 19 In addition, to avoid reporting bias, BP data were automatically stored in the memory of the BP device and were downloaded to a computer by a physician or nurse during clinic visits. And finally, the present study had more BP readings than the previous home BP studies.…”

Section: Bp and Other Measurementsmentioning

confidence: 99%

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Morning and Evening Home Blood Pressure and Risks of Incident Stroke and Coronary Artery Disease in the Japanese General Practice Population

et al. 2016

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Our aim is to determine the optimal time schedule for home blood pressure (BP) monitoring that best predicts stroke and coronary artery disease in general practice. The Japan Morning Surge-Home Blood Pressure (J-HOP) study is a nationwide practice-based study that included 4310 Japanese with a history of or risk factors for cardiovascular disease, or both (mean age, 65 years; 79% used antihypertensive medication). Home BP measures were taken twice daily (morning and evening) over 14 days at baseline. During a mean follow-up of 4 years (16 929 person-years), 74 stroke and 77 coronary artery disease events occurred. Morning systolic BP (SBP) improved the discrimination of incident stroke ( C statistics, 0.802; 95% confidence interval, 0.692–0.911) beyond traditional risk factors including office SBP (0.756; 0.646–0.866), whereas the changes were smaller with evening SBP (0.764; 0.653–0.874). The addition of evening SBP to the model (including traditional risk factors plus morning SBP) significantly reduced the discrimination of incident stroke ( C statistics difference, −0.008; 95% confidence interval: −0.015 to −0.008; P =0.03). The category-free net reclassification improvement (0.3606; 95% confidence interval, 0.1317–0.5896), absolute integrated discrimination improvement (0.015; SE, 0.005), and relative integrated discrimination improvement (58.3%; all P <0.01) with the addition of morning SBP to the model (including traditional risk factors) were greater than those with evening SBP and with combined morning and evening SBP. Neither morning nor evening SBP improved coronary artery disease risk prediction. Morning home SBP itself should be evaluated to ensure best stroke prediction in clinical practice, at least in Japan. This should be confirmed in the different ethnic groups. Clinical Trial Registration— URL: http://www.umin.ac.jp/ctr/ . Unique identifier: UMIN000000894.

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Section: Discussioncontrasting

confidence: 72%

Section: Methodsmentioning

confidence: 99%

Section: Bp and Other Measurementsmentioning

confidence: 99%

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Morning and Evening Home Blood Pressure and Risks of Incident Stroke and Coronary Artery Disease in the Japanese General Practice Population

et al. 2016

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“…It has also been reported that weekly averaged BP could be a good prognostic marker of the incidence of both cardiovascular events and all-cause mortality in hemodialysis patients [25]. It has been reported that home-measured BP, especially systolic BP in the morning on hemodialysis days, can provide pivotal information for the management of hemodialysis patients [26,27]. Thus, home-measured BP was evaluated for a week before and after switching.…”

Section: Discussionmentioning

confidence: 99%

Azilsartan is More Effective as Compared to Olmesartan in Hemodialysis Patients with Uncontrolled Hypertension

Ukimura¹,

Matsuda²,

Yamauchi³

et al. 2014

J Nephrol Ther

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“…We previously performed a cross-sectional study to explore the target home BP level in T2DM patients as a sub-analysis of the Japan Morning Surge Home Blood Pressure (J-HOP) Study (28). The J-HOP study is a prospective observational study evaluating the predictive values of home BP for cardiovascular events in Japanese subjects with any cardiovascular risk factors (29). The study enrolled 4,310 patients (mean age 64.9± 10.9 years; 47.0% men), and clinic and home BP monitoring were performed.…”

Section: New Proposed Target Home Bp In Subjects With T2dmmentioning

confidence: 99%

Blood Pressure Management in Patients with Type 2 Diabetes

Eguchi

2015

Intern. Med.

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In patients with type 2 diabetes (T2DM), the coexistence of hypertension enhances the cardiovascular risk, and the prevention of future cardiovascular disease is an important component of T2DM management. Antihypertensive therapy has been shown to be an effective method of reducing the micro-and macrovascular complications of T2DM, however, the optimal target blood pressure (BP) levels are still under debate. Most of the international guidelines have raised the target clinic BP from 130/80 to 140/90 mmHg, however, the Japanese Society of Hypertension 2014 guidelines kept the target BP level at 130/80 mmHg. However, individualized BP-lowering treatments should be considered in patients with T2DM, especially in high-risk individuals such as those with a history of stroke or retinopathy, and aggressive antihypertensive therapy below 130 mmHg should be initiated even when the initial systolic BP level is <140 mmHg. The authors performed two studies concerning the BP target levels of home BP. In the first study, the authors found that a home BP target <125/75 mmHg was effective in improving the measures of vascular stiffness and kidney damage. In the second study, when the clinic BP target was set at 130/80 mmHg, the home BP could be approximately 130/80 mmHg. More data are needed to individualize the target BP levels of T2DM patients.

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Association of Morning and Evening Blood Pressure at Home With Asymptomatic Organ Damage in the J-HOP Study

Abstract: Morning BP and evening BP provide equally useful information for subclinical target organ damage, yet multivariate modeling highlighted the stand-alone predictive ability of morning BP.

Cited by 71 publications

References 37 publications

Morning and Evening Home Blood Pressure and Risks of Incident Stroke and Coronary Artery Disease in the Japanese General Practice Population

Morning and Evening Home Blood Pressure and Risks of Incident Stroke and Coronary Artery Disease in the Japanese General Practice Population

Azilsartan is More Effective as Compared to Olmesartan in Hemodialysis Patients with Uncontrolled Hypertension

Blood Pressure Management in Patients with Type 2 Diabetes

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