Abstract
Objective: We investigated the prognostic significance of morning home SBP (MHSBP) and clinic SBP (CSBP) at baseline and during follow-up in on-treatment hypertensive patients. Methods: In the Home blood pressure measurement with Olmesartan Naive patients to Establish Standard Target blood pressure study, more than 20000 Japanese hypertensive patients who started treatment with olmesartan were followed for cardiovascular events for 2 years. MHSBP and CSBP measured at baseline and during follow-up were compared in terms of the prognostic significance in predicting cardiovascular events. Results: The analysis included 21591 patients (50.6% female; average age 64.9 years; mean follow-up 2.02 years; and 280 cardiovascular events). The mean MHSBP and CSBP were 151.2 and 153.6mmHg at baseline and 135.2 and 135.2mmHg during follow-up. Hazard ratios per 1mmHg increase were 1.011 (95% confidence interval 1.004-1.019) and 1.006 (1.000-1.012) at baseline, and 1.039 (1.029-1.049) and 1.026 (1.016-1.036) during follow-up. When MHSBP and CSBP at baseline and during follow-up were included in the same model, only MHSBP during follow-up was identified as a significant predictive factor. The concordance index of all blood pressure variables showed reasonable discrimination abilities, and that of mean during follow-up were higher than that of SBP at baseline. The results of net reclassification improvement analyses showed that follow-up MHSBP had better reclassification ability than follow-up CSBP. Conclusion: SBP during follow-up (as compared with SBP at baseline), particularly MHSBP (as compared with CSBP), had better prognostic significance in predicting cardiovascular events in Japanese hypertensive patients during a 2-year clinical study.
Original language | English |
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Pages (from-to) | 1520-1527 |
Number of pages | 8 |
Journal | Journal of Hypertension |
Volume | 34 |
Issue number | 8 |
DOIs | |
State | Published - 1 Aug 2016 |
Externally published | Yes |
Keywords
- ambulatory
- antihypertensive drug treatment
- blood pressure
- blood pressure monitoring
- hypertension
- observational study