Ambulatory versus home versus clinic blood pressure: The association with subclinical cerebrovascular diseases: The Ohasama study

Azusa Hara, Kazushi Tanaka, Takayoshi Ohkubo, Takeo Kondo, Masahiro Kikuya, Hirohito Metoki, Takanao Hashimoto, Michihiro Satoh, Ryusuke Inoue, Kei Asayama, Taku Obara, Takuo Hirose, Shin Ichi Izumi, Hiroshi Satoh, Yutaka Imai

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

The usefulness of ambulatory, home, and casual/clinic blood pressure measurements to predict subclinical cerebrovascular diseases (silent cerebrovascular lesions and carotid atherosclerosis) was compared in a general population. Data on ambulatory, home, and casual/clinic blood pressures and brain MRI to detect silent cerebrovascular lesions were obtained in 1007 subjects aged ≥55 years in a general population of Ohasama, Japan. Of the 1007 subjects, 583 underwent evaluation of the extent of carotid atherosclerosis. Twenty-four-hour, daytime, and nighttime ambulatory and home blood pressure levels were closely associated with the risk of silent cerebrovascular lesions and carotid atherosclerosis (all P<0.05). When home and one of the ambulatory blood pressure values were simultaneously included in the same regression model, each of the ambulatory blood pressure values remained a significant predictor of silent cerebrovascular lesions, whereas home blood pressure lost its predictive value. Of the ambulatory blood pressure values, nighttime blood pressure was the strongest predictor of silent cerebrovascular lesions. The home blood pressure value was more closely associated with the risk of carotid atherosclerosis than any of the ambulatory blood pressure values when home and one of the ambulatory blood pressure values were simultaneously included in the same regression model. The casual/clinic blood pressure value had no significant association with the risk of subclinical cerebrovascular diseases. Although the clinical indications for ambulatory blood pressure monitoring and home blood pressure measurements may overlap, the clinical significance of each method for predicting target organ damage may differ for different target organs.

Original languageEnglish
Pages (from-to)22-28
Number of pages7
JournalHypertension
Volume59
Issue number1
DOIs
Publication statusPublished - 2012 Jan 1
Externally publishedYes

Keywords

  • ambulatory blood pressure
  • carotid atherosclerosis
  • casual/clinic blood pressure
  • general population
  • home blood pressure
  • silent cerebrovascular lesions

ASJC Scopus subject areas

  • Internal Medicine

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  • Cite this

    Hara, A., Tanaka, K., Ohkubo, T., Kondo, T., Kikuya, M., Metoki, H., Hashimoto, T., Satoh, M., Inoue, R., Asayama, K., Obara, T., Hirose, T., Izumi, S. I., Satoh, H., & Imai, Y. (2012). Ambulatory versus home versus clinic blood pressure: The association with subclinical cerebrovascular diseases: The Ohasama study. Hypertension, 59(1), 22-28. https://doi.org/10.1161/HYPERTENSIONAHA.111.174938