Comparison Between Home and Ambulatory Morning Blood Pressure and Morning Hypertension in Their Reproducibility and Associations With Vascular Injury
Abstract
Morning blood pressure (BP) is recommended to be assessed by either 24-hour ambulatory or home BP monitoring. By which methods morning BP assessed is more reproducible and more closely associated with vascular injury remains unknown. We, therefore, addressed this issue in 1049 referred untreated outpatients (51.9% women; average age, 51 years) who had performed 24-hour ambulatory and 7-day home BP monitoring and vascular evaluations. Irrespective of the assessment methods, morning BPs were all significantly ( P ≤0.027) associated with the arterial measures. The partial correlation coefficients of carotid-femoral pulse wave velocity and urinary albumin-to-creatinine ratio with home morning BPs were greater than those with the ambulatory morning pressures among the first 2 hours after awakening (0.21–0.37 versus 0.15–0.24; P <0.05). The associations with home morning systolic BP remained significant ( P ≤0.002) after full adjustment for evening BP, whereas those with ambulatory morning BPs became nonsignificant after full adjustment for 24-hour BP except that of the carotid-femoral pulse wave velocity with ambulatory morning (6:00–10:00) systolic BP. Of the 135 subjects who had both home and repeated 24-hour ambulatory BP monitoring within 1 month, the coefficients of variation were ≈11% for ambulatory morning BPs and 5% for home self-measurements. In conclusion, morning BP, irrespective of the assessment methods and definitions, was generally reproducible and significantly associated with vascular indices. Nevertheless, home morning BP might be preferred than ambulatory measurements because of better reproducibility and stronger correlation with vascular indices.
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One advantage of HBPM is the larger number of readings that can be obtained compared with office blood pressure measurement.
“one of the advantages of HBPM is the larger number of readings that can be obtained compared with office BP (OBP) measurement [17,18].”
The reproducibility of any blood pressure measurement method improves by increasing the number of blood pressure readings.
“The reproducibility of any BP measurement method improves by increasing the number of BP readings”
HBPM and ambulatory blood pressure monitoring have similar reproducibility.
“suggests a similar reproducibility of the two methods”
Both HBPM and ambulatory blood pressure monitoring have better reproducibility than office blood pressure measurement.
“a better reproducibility of both as compared with OBP [18,19]”
Cross-sectional studies have mainly focused on the effect of different numbers of readings and days on average HBP, HBP variability and reproducibility; cross-classification according to office and home BP; association with ABPM values; and association with indices of preclinical target-organ damage.
“Cross-sectional studies have mainly focused on the effect of different numbers of readings and days on average HBP, HBP variability and reproducibility; cross-classification according to office and home BP (normotension, white-coat, masked and sustained hypertension); association with ABPM values and association with indices of preclinical target-organ damage [17,18,127–133]”
The reproducibility of BP information provided by HBPM and ABPM was shown to be similar by direct comparison in the same individuals, or even higher for HBPM.
“An important issue to consider is the reproducibility of BP information provided by HBPM and ABPM, respectively, which was shown to be similar by a direct comparison of HBPM and ABPM data in the same individuals [18,170], or even higher for HBPM [20]”
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- Authors
- Guo, Q.-H., Cheng, Y.-B., Zhang, D.-Y., Wang, Y., Huang, Q.-F., Sheng, C.-S., Xu, T.-Y., Li, Y., & Wang, J.-G.
- Affiliations
- Shanghai Jiao Tong University (CN)
- ORCID
- Venue
- Hypertension
- Published
- 2019-07
- Volume
- 74
- Issue
- 1
- Pages
- 137-144
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- OpenAlex
- W2945027725
- Cited by
- 27
- References
- 30
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 5 · 2023: 3 · 2022: 3 · 2021: 4 · 2020: 5 · 2019: 1
- FWCI
- 2.38
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ruijin Hospital
- 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
- morning blood pressure, morning hypertension, home blood pressure monitoring, ambulatory blood pressure monitoring, reproducibility, vascular injury, carotid-femoral pulse wave velocity, albumin-creatinine ratio, arterial stiffness
- MeSH terms
- Adult, Age Factors, Aged, Blood Pressure Determination, China, Circadian Rhythm, Female, Home Nursing, Humans, Hypertension, Male, Middle Aged, Retrospective Studies, Sex Factors, Reproducibility of Results, Cohort Studies, Risk Assessment, Blood Pressure Monitoring, Ambulatory, Vascular System Injuries
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