Detection of silent cerebrovascular lesions in individuals with 'masked' and 'white-coat' hypertension by home blood pressure measurement: The Ohasama study

Azusa Hara, Takayoshi Ohkubo, Takeo Kondo, Masahiro Kikuya, Yoko Aono, Sugiko Hanawa, Kyoko Shioda, Sayaka Miyamoto, Taku Obara, Hirohito Metoki, Ryusuke Inoue, Kei Asayama, Takuo Hirose, Kazuhito Totsune, Haruhisa Hoshi, Shin Ichi Izumi, Hiroshi Satoh, Yutaka Imai

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Objective To investigate the risk of silent cerebrovascular lesions in individuals with masked hypertension (MHT) and white-coat hypertension. Methods Self-measured home blood pressure (HBP) and casual blood pressure (CBP) measurements were recorded in 1060 individuals at least 55 years of age (mean age, 66.3 years) in a general population of Ohasama, Japan. The relationships between silent cerebrovascular lesions (white matter hyperintensity and lacunar infarct) detected on MRI and four blood pressure groups [sustained normal blood pressure (SNBP), HBP <135/85mmHg, CBP <140/90mmHg; white-coat hypertension, HBP <135/85 mmHg, CBP ≥140/90 mmHg; MHT, HBP ≥135/85mmHg, CBP <140/90 mmHg; sustained hypertension, HBP≥135/85 mmHg, CBP ≥140/90 mmHg] were examined using multivariate analysis adjusted for possible confounding factors. Results The odds ratios of sustained hypertension (1.74, 95% confidence interval 1.18-2.57) and MHT (2.31, 95% confidence interval 1.32-4.04) for the presence of silent cerebrovascular lesions were significantly higher than the odds ratio of SNBP, whereas there was no significant difference between white-coat hypertension and SNBP (1.03, 95% confidence interval 0.75-1.41). The odds ratios for the presence of either lacunar infarct or white matter hyperintensity in the four groups were similar to those for silent cerebrovascular lesions. Conclusion The present study is the first to demonstrate that the risk of silent cerebrovascular lesions is higher with MHT than with SNBP and similar to that of sustained hypertension.

Original languageEnglish
Pages (from-to)1049-1055
Number of pages7
JournalJournal of hypertension
Volume27
Issue number5
DOIs
Publication statusPublished - 2009 May 1
Externally publishedYes

Fingerprint

White Coat Hypertension
Blood Pressure
Masked Hypertension
Lacunar Stroke
Odds Ratio
Confidence Intervals
Hypertension
Blood Group Antigens

Keywords

  • General population
  • Home blood pressure
  • Masked hypertension
  • Silent cerebrovascular lesions
  • White-coat hypertension

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Detection of silent cerebrovascular lesions in individuals with 'masked' and 'white-coat' hypertension by home blood pressure measurement : The Ohasama study. / Hara, Azusa; Ohkubo, Takayoshi; Kondo, Takeo; Kikuya, Masahiro; Aono, Yoko; Hanawa, Sugiko; Shioda, Kyoko; Miyamoto, Sayaka; Obara, Taku; Metoki, Hirohito; Inoue, Ryusuke; Asayama, Kei; Hirose, Takuo; Totsune, Kazuhito; Hoshi, Haruhisa; Izumi, Shin Ichi; Satoh, Hiroshi; Imai, Yutaka.

In: Journal of hypertension, Vol. 27, No. 5, 01.05.2009, p. 1049-1055.

Research output: Contribution to journalArticle

Hara, A, Ohkubo, T, Kondo, T, Kikuya, M, Aono, Y, Hanawa, S, Shioda, K, Miyamoto, S, Obara, T, Metoki, H, Inoue, R, Asayama, K, Hirose, T, Totsune, K, Hoshi, H, Izumi, SI, Satoh, H & Imai, Y 2009, 'Detection of silent cerebrovascular lesions in individuals with 'masked' and 'white-coat' hypertension by home blood pressure measurement: The Ohasama study', Journal of hypertension, vol. 27, no. 5, pp. 1049-1055. https://doi.org/10.1097/HJH.0b013e3283298522
Hara, Azusa ; Ohkubo, Takayoshi ; Kondo, Takeo ; Kikuya, Masahiro ; Aono, Yoko ; Hanawa, Sugiko ; Shioda, Kyoko ; Miyamoto, Sayaka ; Obara, Taku ; Metoki, Hirohito ; Inoue, Ryusuke ; Asayama, Kei ; Hirose, Takuo ; Totsune, Kazuhito ; Hoshi, Haruhisa ; Izumi, Shin Ichi ; Satoh, Hiroshi ; Imai, Yutaka. / Detection of silent cerebrovascular lesions in individuals with 'masked' and 'white-coat' hypertension by home blood pressure measurement : The Ohasama study. In: Journal of hypertension. 2009 ; Vol. 27, No. 5. pp. 1049-1055.
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abstract = "Objective To investigate the risk of silent cerebrovascular lesions in individuals with masked hypertension (MHT) and white-coat hypertension. Methods Self-measured home blood pressure (HBP) and casual blood pressure (CBP) measurements were recorded in 1060 individuals at least 55 years of age (mean age, 66.3 years) in a general population of Ohasama, Japan. The relationships between silent cerebrovascular lesions (white matter hyperintensity and lacunar infarct) detected on MRI and four blood pressure groups [sustained normal blood pressure (SNBP), HBP <135/85mmHg, CBP <140/90mmHg; white-coat hypertension, HBP <135/85 mmHg, CBP ≥140/90 mmHg; MHT, HBP ≥135/85mmHg, CBP <140/90 mmHg; sustained hypertension, HBP≥135/85 mmHg, CBP ≥140/90 mmHg] were examined using multivariate analysis adjusted for possible confounding factors. Results The odds ratios of sustained hypertension (1.74, 95{\%} confidence interval 1.18-2.57) and MHT (2.31, 95{\%} confidence interval 1.32-4.04) for the presence of silent cerebrovascular lesions were significantly higher than the odds ratio of SNBP, whereas there was no significant difference between white-coat hypertension and SNBP (1.03, 95{\%} confidence interval 0.75-1.41). The odds ratios for the presence of either lacunar infarct or white matter hyperintensity in the four groups were similar to those for silent cerebrovascular lesions. Conclusion The present study is the first to demonstrate that the risk of silent cerebrovascular lesions is higher with MHT than with SNBP and similar to that of sustained hypertension.",
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T1 - Detection of silent cerebrovascular lesions in individuals with 'masked' and 'white-coat' hypertension by home blood pressure measurement

T2 - The Ohasama study

AU - Hara, Azusa

AU - Ohkubo, Takayoshi

AU - Kondo, Takeo

AU - Kikuya, Masahiro

AU - Aono, Yoko

AU - Hanawa, Sugiko

AU - Shioda, Kyoko

AU - Miyamoto, Sayaka

AU - Obara, Taku

AU - Metoki, Hirohito

AU - Inoue, Ryusuke

AU - Asayama, Kei

AU - Hirose, Takuo

AU - Totsune, Kazuhito

AU - Hoshi, Haruhisa

AU - Izumi, Shin Ichi

AU - Satoh, Hiroshi

AU - Imai, Yutaka

PY - 2009/5/1

Y1 - 2009/5/1

N2 - Objective To investigate the risk of silent cerebrovascular lesions in individuals with masked hypertension (MHT) and white-coat hypertension. Methods Self-measured home blood pressure (HBP) and casual blood pressure (CBP) measurements were recorded in 1060 individuals at least 55 years of age (mean age, 66.3 years) in a general population of Ohasama, Japan. The relationships between silent cerebrovascular lesions (white matter hyperintensity and lacunar infarct) detected on MRI and four blood pressure groups [sustained normal blood pressure (SNBP), HBP <135/85mmHg, CBP <140/90mmHg; white-coat hypertension, HBP <135/85 mmHg, CBP ≥140/90 mmHg; MHT, HBP ≥135/85mmHg, CBP <140/90 mmHg; sustained hypertension, HBP≥135/85 mmHg, CBP ≥140/90 mmHg] were examined using multivariate analysis adjusted for possible confounding factors. Results The odds ratios of sustained hypertension (1.74, 95% confidence interval 1.18-2.57) and MHT (2.31, 95% confidence interval 1.32-4.04) for the presence of silent cerebrovascular lesions were significantly higher than the odds ratio of SNBP, whereas there was no significant difference between white-coat hypertension and SNBP (1.03, 95% confidence interval 0.75-1.41). The odds ratios for the presence of either lacunar infarct or white matter hyperintensity in the four groups were similar to those for silent cerebrovascular lesions. Conclusion The present study is the first to demonstrate that the risk of silent cerebrovascular lesions is higher with MHT than with SNBP and similar to that of sustained hypertension.

AB - Objective To investigate the risk of silent cerebrovascular lesions in individuals with masked hypertension (MHT) and white-coat hypertension. Methods Self-measured home blood pressure (HBP) and casual blood pressure (CBP) measurements were recorded in 1060 individuals at least 55 years of age (mean age, 66.3 years) in a general population of Ohasama, Japan. The relationships between silent cerebrovascular lesions (white matter hyperintensity and lacunar infarct) detected on MRI and four blood pressure groups [sustained normal blood pressure (SNBP), HBP <135/85mmHg, CBP <140/90mmHg; white-coat hypertension, HBP <135/85 mmHg, CBP ≥140/90 mmHg; MHT, HBP ≥135/85mmHg, CBP <140/90 mmHg; sustained hypertension, HBP≥135/85 mmHg, CBP ≥140/90 mmHg] were examined using multivariate analysis adjusted for possible confounding factors. Results The odds ratios of sustained hypertension (1.74, 95% confidence interval 1.18-2.57) and MHT (2.31, 95% confidence interval 1.32-4.04) for the presence of silent cerebrovascular lesions were significantly higher than the odds ratio of SNBP, whereas there was no significant difference between white-coat hypertension and SNBP (1.03, 95% confidence interval 0.75-1.41). The odds ratios for the presence of either lacunar infarct or white matter hyperintensity in the four groups were similar to those for silent cerebrovascular lesions. Conclusion The present study is the first to demonstrate that the risk of silent cerebrovascular lesions is higher with MHT than with SNBP and similar to that of sustained hypertension.

KW - General population

KW - Home blood pressure

KW - Masked hypertension

KW - Silent cerebrovascular lesions

KW - White-coat hypertension

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