Abstract 12659: Night-time Home Blood Pressure and the Risk of Hypertensive Target Organ Damage: The Japan Morning Surge-Home Blood Pressure (J-HOP) Study
Background: Nighttime blood pressure (BP) in ambulatory BP monitoring has a superior predictive value of hypertensive target organ damage than awake BP. We evaluated whether nighttime BP assessed by a home BP monitor was associated with hypertensive target organ damage.
Methods: We measured clinic BP, out-of-clinic BP including night-time home BP, and the urinary albumin to creatinine ratio (UACR) in 855 patients who had cardiovascular risk factors. Nighttime home BP was measured at 2, 3, and 4 AM in addition to clinic, awake ambulatory, night-time ambulatory, and awake home BP.
Results: Clinic (r=0.186), awake ambulatory (r=0.173), nighttime ambulatory (r=0.194), awake home (r=0.298), and nighttime home (r=0.311) systolic BP (SBP) were associated with log-transformed UACR (all p<0.001). The correlation coefficient of nighttime home BP to log-transformed UACR was significantly greater than that of nighttime ambulatory BP (P<0.001). The goodness of fit of the association between SBP and UACR was improved by adding nighttime home SBP to the other SBP (P<0.001). Each diastolic BP measure was similarly related to UACR. Similar findings were observed for left ventricular mass index in a subgroup of patients.
Conclusion: Nighttime SBP assessed by a home BP monitor is more strongly associated to hypertensive target organ damage than that assessed by ambulatory BP monitor in patients with any cardiovascular risk factors. The measurement of nighttime home SBP improves the association of SBP with hypertensive target organ damage, in addition to other SBP measures.
- © 2012 by American Heart Association, Inc.