Prediction of Stroke by Home “Morning” Versus “Evening” Blood Pressure Values

Asayama, Kei; Kikuya, Masahiro; Obara, Taku; Metoki, Hirohito; Inoue, Ryusuke; Hara, Azusa; Hirose, Takuo; Hoshi, Hiroyuki; Hashimoto, Junichiro; Totsune, Kazuhito; Satoh, Hiroshi; Imai, Yutaka

doi:10.1161/01.hyp.0000240332.01877.11

Cited by 137 publications

(107 citation statements)

References 28 publications

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“…Again, this is in agreement with the Ohasama study, where morning and evening BP equally predicted the risk of stroke. 22 Interestingly, in the Ohasama study, subjects with morning but not evening BP elevation had similar risk of stroke as those with morning and evening BP elevation, whereas those with evening but not morning BP elevation had little difference from normotensives. 22 More importantly, the risk associated with morning hypertension was more pronounced in treated hypertensives.…”

Section: Morning Versus Evening Home Bpmentioning

confidence: 92%

The optimal home blood pressure monitoring schedule based on the Didima outcome study

et al. 2009

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This study investigated the optimal schedule for home blood pressure (HBP) monitoring that has the greatest prognostic ability and provides the most reliable assessment of HBP. The Didima study assessed the value of HBP (duplicate morning and evening measurements, 3 days) in predicting cardiovascular events in the general population (662 adults, 8.2±0.2 years followup). Criteria for the optimal monitoring schedule were stabilization of mean HBP, its variability (standard deviation (s.d.)) and hazard ratios (HRs) of cardiovascular events per 1 mm Hg HBP increase. By averaging more readings (1-12), there was a progressive decline in average HBP and its s.d. and increase in HR, with most of these benefits achieved on the second day (8 readings) and little additional benefit obtained on the third day (12 readings). The first day gave higher and more unstable HBP values (higher s.d.) with less prognostic ability (lower HR). The first HBP readings per occasion gave higher values but with similar prognostic ability as the second readings taken 1 min later. There was little difference in average HBP between morning and evening readings with no prognostic superiority of morning readings. In conclusion, by averaging more readings the average HBP and its variability are reduced and the prognostic ability improved. Any aspect of HBP monitoring (first or second readings, morning or evening) has similar prognostic ability. The first day gives higher and unstable values with lower prognostic ability and should be better discarded. These data validate the HBP monitoring schedule proposed by the European Society of Hypertension.

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Section: Morning Versus Evening Home Bpmentioning

confidence: 92%

The optimal home blood pressure monitoring schedule based on the Didima outcome study

et al. 2009

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“…It has been reported that morning hypertension is a strong risk factor for stroke. 6,13 The difference between the morning and evening self-measured blood pressures is an independent determinant of cardiac dysfunction. 14 The potential cardiovascular advantages of controlling morning hypertension have not been fully demonstrated.…”

Section: Discussionmentioning

confidence: 99%

“…5 Several prospective studies that evaluated self-measured home blood pressure have indicated that morning hypertension, which includes the morning surge, is an important risk factor for stroke and cardiovascular events. 6 Antihypertensive medication is usually prescribed to be taken once in the morning to increase the likelihood of patient adherence. However, this medication schedule does not satisfactorily decrease morning hypertension.…”

Section: Introductionmentioning

confidence: 99%

The optimal timing of antihypertensive medication administration for morning hypertension in patients with cerebral infarction

et al. 2012

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Morning hypertension is an independent risk factor for cardiovascular diseases, particularly stroke. However, the optimal time at which to take antihypertensive medication to treat morning hypertension remains unclear. We prospectively enrolled elderly patients (over 65 years old) with morning hypertension who had suffered an ischemic stroke (or strokes). Additional treatments (one of six arms) were randomly administered for 10 weeks in the morning, in the evening or at bedtime (n¼15 for each time point/medication). The patients measured their blood pressure and heart rate at home for 14 days prior to the intervention and for the final 14 days, and recorded the data in a blood pressure diary. The patients' urinary albumin/creatinine ratios were evaluated before and after the 10-week intervention. A total of 270 patients were enrolled in this study (mean age: 75.6± 5.8 years; female/male ratio: 125/145). Their morning and evening systolic blood pressures were significantly decreased after following any of the study medication dosing schedules (Po0.001). However, the reductions in the differences between the morning and evening systolic blood pressures were significant only when the medication was taken in the evening or at bedtime (Po0.001 with repeated measures analysis of variance). Furthermore, the recovery rate from morning hypertension was also higher when the medication was taken in the evening (40.0%) or at bedtime (45.6%), rather than in the morning (22.2%; P¼0.003 with the v 2 -test). Antihypertensive medication taken in the evening or at bedtime is the most effective in treating morning hypertension when the patient adheres to the medication regimen.

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“…[123][124][125][126] However, home BP measured in the evening also has a high prognostic significance. 117,127 In contrast, there have been a number of reports from Western countries that home BP does not differ between the morning and evening, or that home BP is higher in the evening than in the morning. 128,129 This may be partly explained by the difference in evening BP measurement times (mostly early in the evening in Western countries, and before going to bed in Japan).…”

Section: Masked Hypertensionmentioning

confidence: 99%

“…Both patterns are considered to be possible risk factors of cardiovascular diseases. 109,110,[115][116][117][118] Home BP is usually measured two times a day, that is, in the morning and evening. According to reports from Japan, home BP is higher in the morning than in the evening.…”

Section: Masked Hypertensionmentioning

confidence: 99%

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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Prediction of Stroke by Home “Morning” Versus “Evening” Blood Pressure Values

Cited by 137 publications

References 28 publications

The optimal home blood pressure monitoring schedule based on the Didima outcome study

The optimal home blood pressure monitoring schedule based on the Didima outcome study

The optimal timing of antihypertensive medication administration for morning hypertension in patients with cerebral infarction

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

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