Morning Home Blood Pressure and Cardiovascular Events in a Japanese General Practice Population over 80 Years Old: The J-HOP Study

Dai Kawauchi, Satoshi Hoshide, Kazuomi Kario

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

BACKGROUND Home blood pressure (BP) measurement has been well accepted for use in the diagnosis and treatment of hypertension. However, data regarding the association between home BP levels and cardiovascular events in a general practice population aged ≥80 years are sparse. METHODS We analyzed the cases of 349 patients ≥80 years old from the Japan Morning Surge-Home Blood Pressure (J-HOP) Study, a nationwide practice-based study of 4,310 Japanese with a history of and/or risk factors for cardiovascular disease. Home BP measurements were performed twice daily (morning and evening) over 14 consecutive days at baseline. RESULTS During a median follow-up of 3.0 years, 32 composite cardiovascular events (13 strokes and 19 nonstroke events) occurred. Higher morning systolic BP (SBP) was a significant risk factor for composite cardiovascular events (hazard ratio (HR) per 10mm Hg, 1.23; 95% confidence interval (CI): 1.01-1.50) and stroke events (HR per 10mm Hg, 1.47; 95% CI: 1.08-2.00) after adjustment by the 4-year cardiovascular risk scores and clinic SBP. In the adjusted model, morning diastolic BP also tended to be a significant risk factor of stroke events (HR per 5 mm Hg, 1.43; 95% CI: 1.00-2.05). However, these associations were not found for evening BP or clinic BP. CONCLUSIONS Morning home BP showed a positive linear association with cardiovascular events, especially with stroke. This association was not observed for clinic BP or evening home BP. Based on these results, in very elderly Asian populations, measuring morning home BP might be important in clinical practice regardless of the individual's office BP level.

Original languageEnglish
Pages (from-to)1190-1196
Number of pages7
JournalAmerican Journal of Hypertension
Volume31
Issue number11
DOIs
StatePublished - 15 Oct 2018
Externally publishedYes

Keywords

  • blood pressure
  • cardiovascular event
  • elderly
  • home blood pressure
  • hypertension
  • morning
  • stroke

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