Reliability of morning, before‐dinner, and at‐bedtime home blood pressure measurements in patients with hypertension

Tomitani

Buranakitjaroen

et al. 2018

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A self‐measured home blood pressure (BP)‐guided strategy is an effective practical approach to hypertension management. The Asia BP@Home study is the first designed to investigate current home BP control status in different Asian countries/regions using standardized home BP measurements taken with the same validated home BP monitoring device with data memory. We enrolled 1443 medicated hypertensive patients from 15 Asian specialist centers in 11 countries/regions between April 2017 and March 2018. BP was relatively well controlled in 68.2% of patients using a morning home systolic BP (SBP) cutoff of <135 mm Hg, and in 55.1% of patients using a clinic SBP cutoff of <140 mm Hg. When cutoff values were changed to the 2017 AHA/ACC threshold (SBP <130 mm Hg), 53.6% of patients were well controlled for morning home SBP. Using clinic 140 mm Hg and morning home 135 mm Hg SBP thresholds, the proportion of patients with well‐controlled hypertension (46%) was higher than for uncontrolled sustained (22%), white‐coat (23%), and masked uncontrolled (9%) hypertension, with significant country/regional differences. Home BP variability in Asian countries was high, and varied by country/region. In conclusion, the Asia BP@Home study demonstrated that home BP is relatively well controlled at hypertension specialist centers in Asia. However, almost half of patients remain uncontrolled for morning BP according to new guidelines, with significant country/regional differences. Strict home BP control should be beneficial in Asian populations. The findings of this study are important to facilitate development of health policies focused on reducing cardiovascular complications in Asia.

Section: Discussionmentioning

confidence: 99%

Home blood pressure control status in 2017‐2018 for hypertension specialist centers in Asia: Results of the Asia BP@Home study

Tomitani

Buranakitjaroen

et al. 2018

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“…Lifestyle factors in Asia make it difficult to measure evening BP before dinner; therefore, the Japanese Society of Hypertension guidelines recommend that evening home BP is measured just before going to bed . However, measurements at this time are strongly affected by dinner (including alcohol consumption) and evening behavior (eg, bathing in the evening, which is common in Asia) . Therefore, the reproducibility of evening home BP measured just before going to bed is worse than that for morning home BP .…”

Section: Hope Asia Networkmentioning

confidence: 99%

“…However, measurements at this time are strongly affected by dinner (including alcohol consumption) and evening behavior (eg, bathing in the evening, which is common in Asia) . Therefore, the reproducibility of evening home BP measured just before going to bed is worse than that for morning home BP . Thus, we have recommended morning home BP measurement in clinical practice …”

Section: Hope Asia Networkmentioning

confidence: 99%

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

2020

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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.

“…Home BP monitoring (HBPM) may be the best approach for detecting seasonal variation in BP. By using HBPM, one can detect BP levels and variability according to various time phases, such as morning‐evening, day‐by‐day, and seasonal variations . Morning home BP is more closely associated with the indoor room temperature than with the outdoor temperature, and the average home BP monitoring, especially in the morning, is significantly associated with cardiovascular risk in community‐dwelling individuals and hypertensive patients .…”

Section: Information and Communication Technology (Ict)–based Home Bpmentioning

confidence: 99%

The influence of the ambient temperature on blood pressure and how it will affect the epidemiology of hypertension in Asia

Park

Chia

et al. 2019

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