Uncontrolled hypertension based on morning and evening home blood pressure measurements from the J-HOME study

Taku Obara, Kie Ito, Takayoshi Ohkubo, Taku Shibamiya, Takahiro Shinki, Manami Nakashita, Azusa Hara, Hirohito Metoki, Ryusuke Inoue, Kei Asayama, Masahiro Kikuya, Nariyasu Mano, Yutaka Imai

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)

Abstract

We evaluated the control condition of morning and evening home blood pressure (BP) and compared patients who had isolated uncontrolled morning hypertension and those who had sustained uncontrolled (morning and evening) hypertension using data from the Japan Home versus Office Blood Pressure Measurement Evaluation study. We evaluated 3303 treated hypertensive patients (mean age, 66.210.5 years; men, 44.7%) in Japan. We classified patients into controlled hypertension, isolated uncontrolled evening hypertension, isolated uncontrolled morning hypertension and sustained uncontrolled hypertension, based on the cutoff value of 135/85 mm Hg for both morning and evening home BP. Of the 3303 patients evaluated, 24.6% had isolated uncontrolled morning hypertension, and 42.0% had sustained uncontrolled hypertension. Factors associated with isolated uncontrolled morning hypertension included taking evening BP measurement after drinking alcohol or bathing. Factors associated with sustained uncontrolled hypertension were male gender, diabetes mellitus and renal disease. The regimen of antihypertensive medication was more complex in patients with uncontrolled morning hypertension than in controlled hypertension. Determinants of the difference between patients with isolated uncontrolled morning hypertension and those with sustained uncontrolled hypertension were diabetes mellitus, renal disease and lower prevalence in measuring evening BP after drinking alcohol or bathing. More than a half of the treated patients were classified into uncontrolled morning hypertension, which were associated with poorer prognosis. Classification of morning hypertensive patients into groups with or without evening hypertension may be useful for evaluating patients' total cardiovascular disease risk. Physicians should also consider evening BP measuring condition for adequate evaluation of evening BP values.

Original languageEnglish
Pages (from-to)1072-1078
Number of pages7
JournalHypertension Research
Volume32
Issue number12
DOIs
Publication statusPublished - 2009 Dec 23

Keywords

  • Antihypertensive treatment
  • Evening blood pressure
  • Home blood pressure measurement
  • Morning blood pressure

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

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