How many times should blood pressure be measured at home for better prediction of stoke risk? Ten-year follow-up results from the Ohasama study

Takayoshi Ohkubo, Kei Asayama, Masahiro Kikuya, Hirohito Metoki, Haruhisa Hoshi, Junichiro Hashimoto, Kazuhito Totsune, Hiroshi Satoh, Yutaka Imai

Research output: Contribution to journalArticlepeer-review

223 Citations (Scopus)

Abstract

Objective: To determine the optimum number of blood pressure self-measurements taken at home (home blood pressure) in relation to their predictive value for stroke risk. Methods: We obtained more than 14 measurements of home blood pressure from 1491 people aged ≥ 40 years without a history of stroke in the general population in Japan, and followed them up after a mean period of 10.6 years. The prognostic significance of blood pressure for stroke risk was examined using the Cox proportional hazards regression model, which was adjusted for possible confounding factors. Results: The predictive value of home blood pressure increased progressively with the number of measurements, showing the highest predictive value with the average of whole measurements (mean = 25 measurements, 35% increase in the risk of stroke per 10 mmHg elevation in blood pressure). The initial home blood pressure values (one measurement) showed a significantly greater relation with stroke risk than conventional blood pressure values (mean of two measurements) (19/8% increase in the risk of stroke per 10 mmHg elevation in initial home/conventional systolic blood pressure values, respectively). Conclusions: There was no threshold for the number of home blood pressure measurements within the range of 1-14 measurements for increasing the predictive power of stroke risk, suggesting that as many measurements as possible, preferably more than 14 measurements, is recommended for better prediction of stroke risk. It should be emphasized that home blood pressure has a stronger predictive power than does conventional blood pressure, even for a lower number of measurements.

Original languageEnglish
Pages (from-to)1099-1104
Number of pages6
JournalJournal of hypertension
Volume22
Issue number6
DOIs
Publication statusPublished - 2004 Jun

Keywords

  • Conventional blood pressure
  • General population
  • Home blood pressure
  • Prospective study
  • Stroke

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

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