Expert panel consensus recommendations for ambulatory blood pressure monitoring in Asia: The HOPE Asia Network

Kario, Kazuomi; Shin, Jinho; Chen, Chen Huan; Buranakitjaroen, Peera; Chia, Yook Chin; Divinagracia, Romeo; Nailes, Jennifer; Siddique, Saulat; Sison, Jorge; Soenarta, Arieska Ann; Sogunuru, Guru Prasad; Tay, Jam Chin; Teo, Boon Wee; Turana, Yuda; Zhang, Yuqing; Park, Sungha; Minh, Huynh Van; Wang, Tzung‐Dau

doi:10.1111/jch.13652

Cited by 130 publications

(177 citation statements)

References 248 publications

(308 reference statements)

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“…Several parameters related to nocturnal BP patterns, morning surge, and BP variability were successfully included in the guidelines in Asian countries/regions; this opinion is quite consistent with international guidelines and the Asian consensus on ABPM . Although there are many reports regarding these parameters, however, the clinical usefulness is currently very limited and more evidence is needed for them to be targeted in hypertension treatment.…”

Section: Discussionsupporting

confidence: 55%

“…Thus, in terms of better sensitivity and similar prognostic value, ABPM could be preferred for the diagnosis of MUCH. Moreover, in terms of Asian perspectives, ABPM might be important for some clinical situations, such as morning surge or nocturnal hypertension suspected in high‐risk patients …”

Section: Discussionmentioning

confidence: 99%

“…In fact, there is accumulating evidence that morning surge is more associated with cardiovascular outcomes in Asian populations than in Western populations; furthermore, nocturnal BP is known to be a more important factor in Asian populations because of higher salt intake and salt sensitivity and/or higher central BP . ABPM could be useful for demonstrating BP variabilities . For these reasons, a consensus document from Asian experts was recently published, and more active adoption of ABPM in clinical practice is expected in the future …”

Section: Introductionmentioning

confidence: 99%

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Current status of ambulatory blood pressure monitoring in Asian countries: A report from the HOPE Asia Network

Shin

Kario

Chia

et al. 2019

J of Clinical Hypertension

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Ambulatory blood pressure monitoring (ABPM) can measure 24-hour blood pressure (BP), including nocturnal BP and diurnal variations. This feature of ABPM could be of value in Asian populations for preventing cardiovascular events. However, no study | 385 SHIN et al. ACK N OWLED G M ENTWe would like to thank Editage (www.edita ge.co.kr) for English language editing. CO N FLI C T O F I NTE R E S TJ Shin has received honoraria and sponsorship to attend seminars from Daiichi Sankyo, Takeda, Menarini, MSD, Bristol-Myers Squibb, and Sanofi. Kario K received research grant from A &D Co.; Omron Healthcare Co.; Roche Diagnostics KK; MSD KK; Astellas Pharma Inc; Otsuka Holdings Co.; Otsuka Pharmaceutical Co.; Sanofi KK; Shionogi & Co.; Sanwa Kagaku Kenkyusho Co.; Daiichi Sankyo Co.; Sumitomo Dainippon Pharma Co.; Takeda Pharmaceutical Co.; Mitsubishi Tanabe Pharma Co.; Teijin Pharma; Boehringer Ingelheim Japan Inc; Pfizer Japan Inc; Fukuda Denshi Co. S Siddique has received honoraria from Bayer, GlaxoSmithKline, Pfizer, ICI, and Servier; and travel, accommodation and conference registration support from Atco Pharmaceutical, Highnoon Laboratories, Horizon

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Current status of ambulatory blood pressure monitoring in Asian countries: A report from the HOPE Asia Network

Shin

Kario

Chia

et al. 2019

J of Clinical Hypertension

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“…Increased number of BP measurements in the different conditions during real‐world daily life will be the most important wearable concept of BP monitoring, which increases the accuracy (ie, reduces the standard error) of the estimates of mean BP and BP variability . Daytime ambulatory BP measured by ABPM (which include BPs measured in both sitting and non‐sitting conditions) is a well‐known risk factor . Thus, WBPM could be available to measure BP in various conditions as well as sitting condition.…”

Section: Discussionmentioning

confidence: 99%

“…12 conditions) is a well-known risk factor. 13 Thus, WBPM could be available to measure BP in various conditions as well as sitting condition.…”

Section: Ta B L E 1 Patient Characteristicsmentioning

confidence: 99%

The first study comparing a wearable watch‐type blood pressure monitor with a conventional ambulatory blood pressure monitor on in‐office and out‐of‐office settings

Kario

Shimbo

Tomitani

et al. 2020

J of Clinical Hypertension

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Wearable blood pressure (BP) monitoring devices which measure BP levels accurately both in and out of the office are valuable for hypertension management using digital technology. The authors have conducted the first comparison study of BPs measured by a recently developed wrist‐worn watch‐type oscillometric BP monitoring (WBPM) device, the “HeartGuide,” versus BPs measured by an ambulatory BP monitoring (ABPM) device, A&D TM‐2441, in the office (total of 4 readings alternately measured in the sitting position) and outside the office (30‐minutes interval measurements during daytime) in 50 consecutive patients (mean age 66.1 ± 10.8 years). The 2 BP monitoring devices were simultaneously worn on the same non‐dominant arm throughout the monitoring period. The mean difference (±SD) in systolic BPs (average of 2 readings) between WBPM and ABPM was 0.8 ± 12.8 mm Hg (P = .564) in the office and 3.2 ± 17.0 mm Hg (P < .001) outside the office. The proportion of differences that were within ±10 mm Hg was 58.7% in the office and 47.2% outside the office. In a mixed‐effects model analysis, the temporal trend in the difference between the out‐of‐office BPs measured by the two devices was not statistically significant. In conclusion, the difference between the WBPM and ABPM device was acceptable both in and out of the office.

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Association of Nighttime Masked Uncontrolled Hypertension With Left Ventricular Hypertrophy and Kidney Function Among Patients with Chronic Kidney Disease Not Receiving Dialysis

Ren

Xie

et al. 2022

JAMA Netw Open

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IMPORTANCE Nighttime hypertension is prevalent and associated with adverse outcomes in patients with chronic kidney disease (CKD), but nighttime hypertension, a subtype of masked uncontrolled hypertension (MUCH), is often undetected among patients with controlled office blood pressure. Little attention has been paid to patients with CKD and nighttime MUCH. OBJECTIVETo investigate the prevalence of nighttime MUCH and its associations with cardiovascular and kidney outcomes in patients with CKD who were not receiving dialysis. DESIGN, SETTING, AND PARTICIPANTSThis retrospective cohort study included patients with nondialysis CKD and hypertension, enrolled in Shanghai, China, from July 2012 through November 2020 and followed up for a median of 39 months. EXPOSURESParticipants were classified as having controlled hypertension, sustained hypertension, and MUCH, which was further divided into isolated nighttime MUCH and day-night MUCH, assessed by office and ambulatory blood pressure monitoring. MAIN OUTCOMES AND MEASURES Left ventricular hypertrophy (LVH) was determined by echocardiography. The composite kidney outcome consisted of end-stage kidney diseases (ESKD) and a reduction of estimated glomerular filtration rate (eGFR) by 50% or more. Logistic and Cox regression assessed the associations of hypertension subtypes with LVH and kidney outcomes. RESULTS The 675 patients (425 [63.0%] men; mean [SD] age, 50.8 [15.9] years; mean [SD] eGFR, 61.6 [29.4] mL/min/1.73 m 2 ) included 125 (19.3%) with controlled hypertension, 244 (37.6%) with MUCH, and 280 (43.1%) sustained hypertension. Among patients with MUCH, 2 (0.8%) had isolated daytime MUCH, 154 (63.1%) had isolated nighttime MUCH, and 88 (36.1%) had day-night MUCH.During a median (IQR) follow-up of 39 (19-64) months, 130 composite kidney events, including 97 ESKD events, occurred. Compared with controlled hypertension, MUCH and sustained hypertension were associated with LVH (eg, MUCH: odds ratio [OR], 2.94; 95% CI, 1.18-7.34; P = .02) and the composite kidney outcome (eg, MUCH: hazard ratio [HR], 4.12; 95% CI, 1.75-9.73; P = .001) after adjustment for age, sex, proteinuria, eGFR, and other baseline risk factors. Multivariate-adjusted associations were also significant between day-night MUCH and LVH (OR, 3.26; 95% CI, and between isolated nighttime MUCH and the composite kidney outcome (HR, 4.27; 95% CI, 1.69-10.77). CONCLUSIONS AND RELEVANCEIn this cohort study, nighttime MUCH was common and associated with LVH and poor kidney outcomes among patients with hypertension and nondialysis CKD. These findings suggest that ambulatory blood pressure monitoring was inadequately used in (continued) Key Points Question Is nighttime masked uncontrolled hypertension (MUCH) in patients with chronic kidney disease (CKD) not receiving dialysis associated with worse cardiovascular and kidney outcomes? Findings In this cohort study of 675 patients with hypertension and nondialysis CKD, approximately one-third of patients had nighttime MUCH, consisting of 13.0% day-night MUCH and 22.8...

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Expert panel consensus recommendations for ambulatory blood pressure monitoring in Asia: The HOPE Asia Network

Cited by 130 publications

References 248 publications

Current status of ambulatory blood pressure monitoring in Asian countries: A report from the HOPE Asia Network

Current status of ambulatory blood pressure monitoring in Asian countries: A report from the HOPE Asia Network

The first study comparing a wearable watch‐type blood pressure monitor with a conventional ambulatory blood pressure monitor on in‐office and out‐of‐office settings

Association of Nighttime Masked Uncontrolled Hypertension With Left Ventricular Hypertrophy and Kidney Function Among Patients with Chronic Kidney Disease Not Receiving Dialysis

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