Cited by 144Blood Pressure and Hypertension StudiesCardiovascular Health and Disease PreventionNon-Invasive Vital Sign Monitoring

Evidence and Perspectives on the 24-hour Management of Hypertension: Hemodynamic Biomarker-Initiated ‘Anticipation Medicine’ for Zero Cardiovascular Event

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Kario, Kazuomi·2016·Progress in Cardiovascular Diseases

Abstract

There are notable differences between Asians and Westerners regarding hypertension (HTN) and the relationship between HTN and cardiovascular disease (CVD). Asians show greater morning surges in blood pressure (BP) and a steeper slope illustrating the link between higher BP and the risk of CVD events. It is thus particularly important for Asian hypertensives to achieve 24-h BP control, including morning and night-time control. There are three components of 'perfect 24-h BP control:' the 24-h BP level, nocturnal BP dipping, and BP variability (BPV), such as the morning BP surge that can be assessed by ambulatory BP monitoring. The morning BP-guided approach using home BP monitoring (HBPM) is the first step toward perfect 24-h BP control, followed by the control of nocturnal HTN. We have been developing new HBPM devices that can measure nocturnal BP. BPV includes different time-phase variability from the shortest beat-by-beat, positional, diurnal, day-by-day, visit-to-visit, seasonal, and yearly changes. The synergistic resonance of each type of BPV would produce a great dynamic BP surge (resonance hypothesis), which triggers a CVD event, especially in the high-risk patients with systemic hemodynamic atherothrombotic syndrome (SHATS). In the future, the innovative management of HTN based on the simultaneous assessment of the resonance of all of the BPV phenotypes using a beat by beat wearable 'surge' BP monitoring device (WSP) and an information and communication technology (ICT)-based data analysis system will produce a paradigm shift from 'dots' BP management to 'seamless' ultimate individualized 'anticipation medication' for reaching a zero CVD event rate.

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Authors
Kario, K.
Affiliations
Jichi Medical University (JP)
Corresponding author
Kario, Kazuomi
Venue
Progress in Cardiovascular Diseases
Publisher
Elsevier BV
Published
2016-11
Volume
59
Issue
3
Pages
262-281
ISSN
0033-0620 (ISSN-L)
OpenAlex
W2318920883
Cited by
144
References
13
Citations by year
2026: 3 · 2025: 8 · 2024: 7 · 2023: 7 · 2022: 18 · 2021: 14 · 2020: 25 · 2019: 15 · 2018: 25 · 2017: 17 · 2016: 5
FWCI
3.65
Type
journal article
Language
en
Open access
Locations
  • Progress in Cardiovascular Diseases (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Funders
  • Japan Agency for Medical Research and Development
  • Japan Society for the Promotion of Science (26293192)
  • Banyu Life Science Foundation International
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
  • Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
Keywords
hypertension, 24-hour blood pressure control, nocturnal blood pressure dipping, blood pressure variability, morning blood pressure surge, ambulatory blood pressure monitoring, home blood pressure monitoring, wearable blood pressure monitoring, cardiovascular events, hemodynamic biomarkers
MeSH terms
Blood Pressure, Circadian Rhythm, Humans, Hypertension, Blood Pressure Monitoring, Ambulatory, Disease Management, Asian People

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