Nighttime Home Blood Pressure and the Risk of Hypertensive Target Organ Damage
Abstract
In ambulatory blood pressure (BP) monitoring, nighttime BP has a superior ability to predict hypertensive target organ damage than awake BP. We evaluated whether nighttime BP, assessed by a home BP monitor, was associated with hypertensive target organ damage. We measured clinic BP, out-of-clinic BP including nighttime home BP, and the urinary albumin:creatinine ratio (UACR) in 854 patients who had cardiovascular risk factors. Nighttime home BP was measured at 2:00, 3:00, and 4:00 am, in addition to clinic, awake ambulatory, nighttime ambulatory, and awake home BP. Nighttime home systolic BP (SBP) was slightly higher than nighttime ambulatory SBP (difference, 2.6 mm Hg; P <0.001). Clinic ( r =0.186), awake ambulatory ( r =0.173), nighttime ambulatory ( r =0.194), awake home ( r =0.298), and nighttime home ( r =0.311) SBPs were all associated with log-transformed UACR (all P <0.001). The correlation coefficient for the relationship between nighttime home SBP and log-transformed UACR was significantly greater than that for the relationship between nighttime ambulatory SBP and log-transformed UACR ( P <0.001). The goodness of fit of the association between SBP and UACR was improved by adding nighttime home SBP to the other SBPs ( P <0.001). Nighttime home diastolic BP also improved the goodness-of-fit of the association between diastolic BP and UACR ( P =0.001). Similar findings were observed for the left ventricular mass index in the subgroup (N=594). In conclusion, nighttime home BP is slightly different from (but comparable to) nighttime ambulatory BP. The addition of nighttime home BP to other BP measures improves the association of BP with hypertensive target organ damage.
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The correlation of left ventricular mass index with home blood pressure is superior to that with office blood pressure.
“and superior to that with OBP (0.23/0.19, 10 studies) [26].”
A meta-analysis of four studies found only weak correlations of home and office systolic/diastolic blood pressure with carotid intima-media thickness, with no evident differences between the two blood pressure-measuring methods.
“A meta-analysis of four studies found only weak correlations of home and office SBP/DBP with carotid intima--media thickness (cIMT) with no evident differences between the two BP-measuring methods [26].”
A systematic review reported similar correlations between urinary protein excretion and home and office blood pressure values based on evidence from two studies.
“A systematic review reported similar correlations between urinary protein excretion and HBP and OBP values based on evidence from two studies [26].”
In a meta-analysis of 14 studies, echocardiographically measured left ventricular mass index correlated with home systolic/diastolic blood pressure with pooled correlation coefficients of 0.46/0.28.
“In a meta-analysis of 14 studies, echocardiographically measured left ventricular mass index (LVMI) correlated with home SBP/DBP with pooled correlation coefficients of 0.46/0.28, respectively.”
The correlation of left ventricular mass index with home blood pressure is similar to that with ambulatory blood pressure.
“These correlations were similar to that with ABP (0.37/0.26, 9 studies)”
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Chapter 2. Measurement and clinical evaluation of blood pressure
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Self-citationHome (Self) Monitoring of Blood Pressure in Clinical Trials
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Diagnostic Value of Home Blood Pressure
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10 – Home Monitoring of Blood Pressure
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- Authors
- Ishikawa, J., Hoshide, S., Eguchi, K., Ishikawa, S., Shimada, K., Kario, K., & for the Japan Morning Surge-Home Blood Pressure Study Investigators Group
- Affiliations
- Jichi Medical University (JP)
- Venue
- Hypertension
- Published
- 2012-10
- Volume
- 60
- Issue
- 4
- Pages
- 921-928
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- OpenAlex
- W2147405230
- Cited by
- 123
- References
- 27
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 9 · 2023: 4 · 2022: 6 · 2021: 12 · 2020: 13 · 2019: 13 · 2018: 11 · 2017: 5 · 2016: 13 · 2015: 10 · 2014: 7 · 2013: 8
- FWCI
- 5.15
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Omron Healthcare
- Stony Brook University
- 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
- Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
- Keywords
- nocturnal blood pressure, home blood pressure monitoring, hypertensive target organ damage, urinary albumin-creatinine ratio, ambulatory blood pressure monitoring, left ventricular mass, systolic blood pressure, diastolic blood pressure, cardiovascular risk factors
- MeSH terms
- Aged, Aged, 80 and over, Albuminuria, Blood Pressure, Cardiovascular Diseases, Creatinine, Female, Humans, Hypertension, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Risk, Hypertrophy, Left Ventricular, Blood Pressure Monitoring, Ambulatory
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