Abstract 17543: Associations between Awake and Asleep Home Blood Pressure and Biomarkers in the Baseline Data of the Japan Morning Surge-Home Blood Pressure (J-HOP) Vascular Study
Objectives. To study the associations of clinic BP (CBP) vs self-measured home BP (HBP) with new biomarkers and their pathological BP thresholds in the baseline data of the Japan Morning Surge-Home Blood Pressure (J-HOP) Vascular Study, a large cohort with the highest number of home BP measurements (n=84 per person) using the same semiautomatic device.
Methods. The J-HOP Study enrolled 4019 patients with at least one cardiovascular risk factor and asked them to self-measure BP at home using a semiautomatic BP monitoring device with data memory (Medinote, Omlon Inc.) 3 times in the morning (Morning HBP), 3 times in evening (Evening HBP), and 3 times during sleep (at 2:00AM, 3:00AM, and 4:00AM (Sleep HBP)) for 14 days. We also measured the plasma levels of cardiac biomarkers (high sensitive cardiac troponin T [hs-cTnT], B-type natriuretic peptide [BNP], N-terminal pro-hormone BNP [NT-proBNP]) and the urinary albumin/creatinine ratio (UACR).
Results. All 4 of these biomarkers were curvilinearly associated with both CBP and HBPs. The Awake home SBP (Awake HSBP, the average of Morning and Evening systolic HBPs) was more closely associated with these 4 biomarkers than CBP, and the strongest association was found with the association between Awake HSBP and UACR. The thresholds of the significant increase were 160 mmHg for clinic SBP and 145 mmHg for Awake HSBP, and 130 mmHg for Sleep HSBP with cardiac biomarkers, and: 140 mmHg for CSBP and 135 mmHg for Awake HSBP, and 120 mmHg for Sleep HSBP with UACR.
Conclusion. The biomarkers were more closely and independently associated with home BP than clinic BP with the thresholds, indicating that lowering home BP may be more important than lowering clinic BP for target organ protection. The thresholds of the levels of both clinic and self-measured home BP including the sleep period for significant increases were lower for UACR than for cardiac biomarkers. The threshold of sleep BP self-measured at home for a significant increase in UACR was the same as that measured by ambulatory BP monitoring.
- © 2012 by American Heart Association, Inc.