Home blood pressure measurement has a stronger predictive power for mortality than does screening blood pressure measurement

Ohkubo, Takayoshi; Imai, Yutaka; Tsuji, Ichiro; Nagai, Kenichi; Kato, Jun; Kikuchi, Noriko; Nishiyama, Akimitsu; Aihara, Akiko; Sekino, Makoto; Kikuya, Masahiro; Ito, Sadayoshi; Satoh, Hiroshi; Hisamichi, Shigeru

doi:10.1097/00004872-199816070-00010

Cited by 680 publications

(496 citation statements)

References 16 publications

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“…However, the use of ambulatory and home BP monitoring allowed the recognition of the phenomena of masked hypertension (MH) and the white coat hypertension (WCH), which remain undetected when BP is assessed only in the clinic environment. [1][2][3] The phenomenon of MH is common, 4-7 yet only recently its clinical significance has been recognized. 8,9 Studies have shown that masked hypertensives have frequent target organ damage and higher cardiovascular risk than normotensives or white coat hypertensives.…”

Section: Introductionmentioning

confidence: 99%

Masked, white coat and sustained hypertension: comparison of target organ damage and psychometric parameters

Konstantopoulou

Papargyriou

et al. 2009

J Hum Hypertens

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Masked hypertension is defined as low clinic and elevated out-of-clinic pressure (blood pressure, BP) assessed either by patients at home or by ambulatory monitoring. This study compared the cardiovascular status and psychometric characteristics of masked, white coat and sustained hypertensives. Three groups of consecutive subjects with masked (n ¼ 100, age 59 ± 11 years), white coat (n ¼ 100, 60 ± 10 years) and sustained hypertension (n ¼ 100, 60 ± 11 years) diagnosed by ambulatory BP monitoring were compared. Masked hypertensives had higher educational level, exercised more frequently, received fewer drugs and sensed more responsibilities at work than at home. Their left ventricular hypertrophy indexes fall inbetween those with white coat and sustained, the latter having the highest values. The estimated total cardiovascular risk was intermediate between white coat and sustained, whereas their cardiovascular morbidity and renal disease was higher than that of white coat and similar to sustained. Psychological profile analysis showed lower score for type-A personality and their mood behaviour in the hypomania-euthymia range compared with white coat and sustained hypertensives. The cardiovascular risk of masked hypertensives is higher than that of white coat and similar to sustained. Masked hypertensives have higher educational level, better physical training and different personality/mood pattern than white coat and sustained.

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Section: Introductionmentioning

confidence: 99%

Masked, white coat and sustained hypertension: comparison of target organ damage and psychometric parameters

Konstantopoulou

Papargyriou

et al. 2009

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%

“…In the Ohasama Study, home BP on a single measurement in the morning on one day was reported to have more prognostic significance than the mean clinic BP of two measurements, and the mean value of home BP over 21 days (21 measurements) had even more prognostic significance. 34 The clinical significance of home BP has been markedly improved by calculating the mean over a long time, even when the measurement frequency is once on one occasion. 34 Also, in the Finn Home Study, home BP was measured in 464 subjects two times each in the morning and evening for 7 days.…”

Section: Recommendationmentioning

confidence: 99%

“…34 The clinical significance of home BP has been markedly improved by calculating the mean over a long time, even when the measurement frequency is once on one occasion. 34 Also, in the Finn Home Study, home BP was measured in 464 subjects two times each in the morning and evening for 7 days. There was little difference between the mean values on the first and seventh days.…”

Section: Recommendationmentioning

confidence: 99%

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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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“…HBP monitoring has the potential to involve patients actively in disease management and control, it helps to diagnose white coat hypertension, 1 has more prognostic significance 2,3 and correlates better with target organ damage 4,5 than clinic blood pressure (CBP). Furthermore, it is generally associated with a better compliance to treatment and, in some studies, with a better blood pressure control.…”

Section: Introductionmentioning

confidence: 99%

Accuracy of telemedical home blood pressure measurement in the diagnosis of hypertension

et al. 2003

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This study was conducted to compare the accuracy of clinic blood pressure (CBP) and telemedical home blood pressure (HBP) measurement in the diagnosis of hypertension in primary care. The study subjects were 411 patients with average CBP X140 mmHg systolic or X90 mmHg diastolic, who performed telemedical HBP measurement (5 days, four times daily) and ambulatory blood pressure (ABP) monitoring in random order. Main outcome measure was the agreement of CBP and HBP with daytime ABP. CBP was much higher than daytime ABP and average HBP (Po0.001) with no difference between the latter two. The correlation between CBP and ABP was weak (systolic: r ¼ 0.499, diastolic: r ¼ 0.543), whereas strong correlations existed between HBP and ABP (systolic: r ¼ 0.847, diastolic: r ¼ 0.812). A progressive improvement in the strength of the linear regression between average HBP of single days and ABP was obtained from day 1 to day 4, with no further benefit obtained on the fifth day. The HBP readings taken at noon and in the afternoon showed significantly stronger correlations with ABP than the blood pressures measured in the morning and in the evening. In conclusion, the accuracy of telemedical HBP measurement was substantially better than that of CBP in the diagnosis of hypertension in primary care. HBP most accurately reflected ABP on the fourth day of monitoring, and the readings at noon and in the afternoon seemed to be most accurate.

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Home blood pressure measurement has a stronger predictive power for mortality than does screening blood pressure measurement

Cited by 680 publications

References 16 publications

Masked, white coat and sustained hypertension: comparison of target organ damage and psychometric parameters

Masked, white coat and sustained hypertension: comparison of target organ damage and psychometric parameters

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

Accuracy of telemedical home blood pressure measurement in the diagnosis of hypertension

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