Direct Comparison of Home Versus Ambulatory Defined Nocturnal Hypertension for Predicting Cardiovascular Events: The Japan Morning Surge-Home Blood Pressure (J-HOP) Study
Abstract
The home blood pressure monitoring (HBPM) method that measures blood pressure during sleep hours was reported to be comparable to ambulatory blood pressure monitoring (ABPM) in measuring nighttime blood pressure and detecting nocturnal hypertension. The aim of this study was to directly compare the prognostic power of nocturnal hypertension detected by HBPM versus ABPM for predicting future cardiovascular events. We analyzed nighttime blood pressure (measured by HBPM and ABPM) data of 1005 participants who were included in the J-HOP study (Japan Morning Surge-Home Blood Pressure). During a follow-up period of 7.6±3.4 years, 80 cardiovascular disease events occurred. The majority (91.8%) of our study population were hypertensive, and 80.7% of participants were using antihypertensive medication. Nighttime home systolic blood pressure (SBP) was higher compared to nighttime ambulatory SBP (123.0±14.6 versus 120.3±14.4 mm Hg, P <0.001). Nocturnal hypertension was defined as nighttime home or ambulatory SBP of ≥120 mm Hg. The number of participants with nocturnal hypertension defined by HBPM and ABPM was 564 (56.1%) and 469 (46.7%), respectively. Nocturnal hypertension defined by HBPM was associated with increased risk of future cardiovascular events: total cardiovascular events (coronary artery disease and stroke events; 1.78 [1.00–3.15]) and stroke (2.65 [1.14–6.20]), independent of office SBP. These results were absent with nocturnal hypertension defined by ABPM. This is the first comparison prospective study illustrating that uncontrolled nocturnal hypertension defined by HBPM (independent of office SBP) is a predictor of future cardiovascular events.
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Nocturnal BP assessed by ABPM has superior prognostic ability compared with OBP and daytime ambulatory or home BP measurements.
“There is evidence that nocturnal BP assessed by ABPM has superior prognostic ability compared with OBP and daytime ambulatory or home BP measurements [221,222].”
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- Authors
- Mokwatsi, G. G., Hoshide, S., Kanegae, H., Fujiwara, T., Negishi, K., Schutte, A. E., & Kario, K.
- Affiliations
- Jichi Medical University (JP)
- Genki Plaza Medical Center for Health Care (JP)
- North-West University (ZA)
- ORCID
- Venue
- Hypertension
- Published
- 2020-08
- Volume
- 76
- Issue
- 2
- Pages
- 554-561
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- OpenAlex
- W3034474100
- Cited by
- 53
- References
- 29
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 8 · 2023: 9 · 2022: 9 · 2021: 11 · 2020: 3
- FWCI
- 5.01
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Boloka Institutional Repository (North-west University) (submittedVersion)
- Funders
- Japan Society for the Promotion of Science (17K09522)
- 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 hypertension, home blood pressure monitoring, ambulatory blood pressure monitoring, nocturnal blood pressure, cardiovascular events, stroke, coronary artery disease, prognostic value, J-HOP study
- MeSH terms
- Aged, Blood Pressure, Cardiovascular Diseases, Female, Humans, Hypertension, Japan, Male, Middle Aged, Prognosis, Prospective Studies, Risk Factors, Blood Pressure Monitoring, Ambulatory
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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