Repeated evening home blood pressure measurement improves prognostic significance for stroke: A 12-year follow-up of the ohasama study

Kei Asayama, Takayoshi Ohkubo, Azusa Hara, Takuo Hirose, Daisaku Yasui, Taku Obara, Hirohito Metoki, Ryusuke Inoue, Masahiro Kikuya, Kazuhito Totsune, Haruhisa Hoshi, Hiroshi Satoh, Yutaka Imai

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15 Citations (Scopus)

Abstract

Objective To compare the predictive power of home blood pressure (HBP) measured in the evening (E-HBP) and that of casual screening BP (CBP) for stroke risk in relation to the number of E-HBP measurements. Methods We obtained E-HBP (measured once in the evening just before going to bed for 4 weeks) and CBP (measured twice during the health checkup) from 2234 Japanese participants aged ^ 35 years who had no history of a previous stroke. The participants were followed-up for a median duration of 11.9 years. The multivariate adjusted relative hazard (RH) and 95% confidence intervals (CI) for each 10mmHg (systolic) or 5mmHg (diastolic) increase in BP was determined by Cox regression model. Results There were 226 incidences of stroke. Even the initial E-HBP values significantly predicted future stroke events (systolic RH = 1.19. 95% CI = 1.11-1.28; diastolic RH = 1.12. 95% CI = 1.06-1.19). and the predictive power of E-HBP increased progressively with the increased number of measurements. When initial systolic E-HBP and systolic CBP values were simultaneously included into the Cox model. only initial E-HBP was significantly related with stroke risk (E-HBP RH = 1.17. 95% CI = 1.08-1.26; CBP RH = 1.07. 95% CI=0.99-1.15). Conclusion E-HBP has a stronger predictive power than CBP regardless of the number of measurements. Our findings emphasize the important clinical significance of E-HBP over CBP. even though the measurement conditions of E-HBP are generally less strict than that of morning HBP measurements.

Original languageEnglish
Pages (from-to)93-98
Number of pages6
JournalBlood Pressure Monitoring
Volume14
Issue number3
DOIs
Publication statusPublished - 2009 Jun

Keywords

  • Evening home blood pressure
  • General population
  • Home blood pressure
  • Measurement number
  • Ohasama study
  • Stroke

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine
  • Assessment and Diagnosis
  • Advanced and Specialised Nursing

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  • Cite this

    Asayama, K., Ohkubo, T., Hara, A., Hirose, T., Yasui, D., Obara, T., Metoki, H., Inoue, R., Kikuya, M., Totsune, K., Hoshi, H., Satoh, H., & Imai, Y. (2009). Repeated evening home blood pressure measurement improves prognostic significance for stroke: A 12-year follow-up of the ohasama study. Blood Pressure Monitoring, 14(3), 93-98. https://doi.org/10.1097/MBP.0b013e32832a9d91