Is home blood pressure variability itself an interventional target beyond lowering mean home blood pressure during anti-hypertensive treatment?
Open accessAbstract
It is unknown whether home blood pressure (BP) variability reduction is associated with target organ damage (TOD) protection independently of home mean BP reduction. We enrolled 310 hypertensive patients whose systolic BP (SBP) at home was over 135 mm Hg. The subjects measured their BP in the morning and evening for 7 days. In addition, we measured urinary albumin excretion (UAE) as a marker of TOD before and after 6 months of candesartan treatment (+thiazidediuretics). At baseline, UAE was associated with average home SBP (r=0.24, P<0.001), the s.d. of home SBP (r=0.15, P=0.011), and the maximum home SBP (r=0.27, P<0.001). During the intervention, significant reductions were found in average home SBP (146±13 vs. 132±12 mm Hg, P<0.001), s.d. of home SBP (12.9±4.8 vs. 11.8±4.4 mm Hg, P<0.001), and maximum home SBP (172.5±18.0 vs. 155.9±17.5 mm Hg, P<0.001). UAE levels were significantly reduced after 6 months of therapy compared with baseline (18.9 vs. 12.1 mg g(-1) Cre, P<0.001). In multiple regression analysis, the treatment-induced reduction in UAE was significantly associated with that of average home BP (P=0.003) but was not associated with that of s.d. of home SBP or that of maximum home SBP. Home BP variability is not itself an interventional target beyond lowering mean home BP during anti-hypertensive treatment.
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HBPV was superior to OBP variability in the Didima study.
“HBPV was superior to OBP variability in the Didima study [250].”
There is no unequivocal evidence that HBPV reduction may provide benefits in terms of HMOD or risk of events independently of average BP reduction, because of lack of ad hoc intervention trials.
“Also, there is no unequivocal evidence that HBPV reduction may provide benefits in terms of HMOD or risk of events independently of average BP reduction, because of lack of ad hoc intervention trials [253,254].”
Cites
Rothwell, P. M., Howard, S. C., Dolan, E., O'Brien, E., Dobson, J. E., Dahlöf, B., Sever, P. S., & Poulter, N. R. (2010) · The Lancet · doi:10.1016/s0140-6736(10)60308-x · Cited by 1,784 · see citing works
Kario, K., Pickering, T. G., Umeda, Y., Hoshide, S., Hoshide, Y., Morinari, M., Murata, M., Kuroda, T., Schwartz, J. E., & Shimada, K. (2003) · Circulation · doi:10.1161/01.cir.0000056521.67546.aa · Cited by 1,250 · see citing works
Self-citationMaximum Value of Home Blood Pressure: A Novel Indicator of Target Organ Damage in Hypertension
Matsui, Y., Ishikawa, J., Eguchi, K., Shibasaki, S., Shimada, K., & Kario, K. (2011) · Hypertension · doi:10.1161/hypertensionaha.111.171645 · Cited by 127 · see citing works
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Parati, G., Stergiou, G. S., Bilo, G., Kollias, A., Pengo, M., Ochoa, J. E., Agarwal, R., Asayama, K., Asmar, R., Burnier, M., et al. (2021) · Journal of Hypertension · doi:10.1097/hjh.0000000000002922 · Cited by 178 · see citing works
Self-citationHer, A.-Y., Kim, Y. H., Rim, S.-J., Kim, J.-Y., Choi, E.-Y., Min, P.-K., Lee, B.-K., Hong, B.-K., & Kwon, H. M. (2014) · Anadolu Kardiyoloji Dergisi/The Anatolian Journal of Cardiology · doi:10.5152/akd.2014.5119 · Cited by 12 · see citing works
Home (Self) Monitoring of Blood Pressure in Clinical Trials
Stergiou, G. S., & Ntineri, A. (2016) · Blood Pressure Monitoring in Cardiovascular Medicine and Therapeutics · doi:10.1007/978-3-319-22771-9_19 · Cited by 7 · see citing works
- Authors
- Hoshide, S., Yano, Y., Shimizu, M., Eguchi, K., Ishikawa, J., & Kario, K.
- Affiliations
- Jichi Medical University (JP)
- Corresponding author
- Hoshide, Satoshi
- Venue
- Hypertension Research
- Published
- 2012-04-05
- Volume
- 35
- Issue
- 8
- Pages
- 862-866
- ISSN
- 0916-9636 (ISSN-L)
- 1348-4214
- OpenAlex
- W2072847348
- Cited by
- 28
- References
- 3
- Citations by year
- 2021: 2 · 2020: 1 · 2019: 3 · 2018: 4 · 2017: 3 · 2016: 3 · 2015: 5 · 2014: 4 · 2013: 1 · 2012: 1
- FWCI
- 2.26
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Hypertension Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Japan Heart Foundation
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Keywords
- home blood pressure, target organ damage, urinary albumin excretion, candesartan, thiazide diuretics, antihypertensive therapy, systolic blood pressure, hypertension
- MeSH terms
- Aged, Albuminuria, Antihypertensive Agents, Benzimidazoles, Biphenyl Compounds, Blood Pressure, Creatinine, Diuretics, Female, Humans, Hypertension, Male, Middle Aged, Nephelometry and Turbidimetry, Tetrazoles, Linear Models, Treatment Outcome, Blood Pressure Monitoring, Ambulatory, Angiotensin II Type 1 Receptor Blockers
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