Nighttime Blood Pressure Measured by Home Blood Pressure Monitoring as an Independent Predictor of Cardiovascular Events in General Practice

Shimbo

Tomitani

et al. 2020

Self Cite

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.

Section: Discussionmentioning

confidence: 82%

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

Shimbo

Tomitani

et al. 2020

Self Cite

“…The J‐HOP study used a specific HBPM device that automatically measured nocturnal home BP during sleep. Key findings were as follows: (a) morning BP is a more important risk factor of stroke than evening BP; (b) day‐by‐day home BPV is significant predictor of cardiovascular events independent of the average of home BP level; and (c) nocturnal home BP is a risk factor for cardiovascular events independent of office and morning home BP . The HONEST study, the largest nationwide Japanese observational trial, confirmed morning home BP as a strong predictor of both coronary artery disease and stroke events, and showed that morning home SBP <125 mm Hg was associated with minimal risk of cardiovascular events in high‐risk patients with diabetes or history of stroke .…”

Section: Hope Asia Networkmentioning

confidence: 93%

“…A recent study also demonstrated that morning home BP was more reproducible and better correlated with vascular indices than ambulatory BP . To date, there have been five general practitioner‐based home BP cohort studies (Table ), including the HOMED‐BP (Hypertension Objective Treatment Based on Measurement by Electrical Devices of Blood Pressure) study, the J‐HOP (Japan Morning Surge‐Home Blood Pressure) study, and the HONEST (Home Blood Pressure Measurement With Olmesartan Naive Patients to Establish Standard Target Blood Pressure) study . All of these showed that morning home BP was a better predictor of cardiovascular events than office BP.…”

Section: Hope Asia Networkmentioning

confidence: 99%

The HOPE Asia Network activity for “zero” cardiovascular events in Asia: Overview 2020

2020

Self Cite

The impact of hypertension-related cardiovascular disease and target organ damage, and therefore the benefits of blood pressure (BP) control, is greater in Asian than in Western countries. Asia-specific features of hypertension and its effective management are important and active areas of research. The Hypertension Cardiovascular Outcome Prevention and Evidence in Asia (HOPE Asia) Network was formed in 2016and is now a member of the World Hypertension League. The main goal of the HOPE Asia Network is to improve the management of hypertension and organ protection toward achieving "zero" cardiovascular events in Asia. Considerable work has already been done on the journey to achieving this goal. We have shown that BP control status in Asia differs between countries, and even between regions within the same country. Several expert panel consensus recommendations and clinical guidance papers are available to support the use of home and ambulatory BP monitoring in the region. In addition, the AsiaBP@Home study prospectively investigated home BP control status across 15 specialist centers using the same validated device and measurement schedule. We have also proposed the concept of systemic hemodynamic atherothrombotic syndrome (SHATS), a vicious cycle of BP variability and vascular disease on cardiovascular events and organ damage, and suggested a SHATS score for risk stratification for clinical practice. This special issue of the journal collates Asia-specific resources and data, contributing to advances in hypertension management and cardiovascular disease prevention in the region.

“…This device automatically measures BP at fixed intervals during sleep using a cuff placed on the patient's arm just before going to bed; BP data are stored in the device memory. It was used to monitor nighttime BP in the J‐HOP study, which showed that self‐measurement of nighttime home BP was feasible and recorded BP values similar to those obtained with ABPM . Data from J‐HOP also showed that nighttime home BP was a reliable indicator of target organ damage, even more so than nighttime ABPM determined using ABPM .…”

Section: Development Of Nocturnal Hbpm Devices and Evidencementioning

confidence: 97%

Diversity of and initiatives for hypertension management in Asia—Why we need the HOPE Asia Network

Chia

Sukonthasarn

et al. 2019

Self Cite

The Hypertension Cardiovascular Outcome Prevention and Evidence in Asia (HOPE Asia) Network was set up to improve the management of hypertension in Asia with the ultimate goal of achieving "zero" cardiovascular events. Asia is a diverse continent, and the prevalence of hypertension has increased over the last 30 years. There are a number of Asia-specific features of hypertension and hypertension-related cardiovascular complications, which means that a region-specific approach is needed. White-coat hypertension will become more of an issue over time as Asian populations age, and masked hypertension is more prevalent in Asian than in Western countries.Medical writing assistance was provided by Nicola Ryan, independent medical writer. Editorial assistance was provided by Ayako