Abstract 13328: Association of Morning and Evening Blood Pressure at Home With Target Organ Damage in the J-HOP Study
Background: Several guidelines recommend that home blood pressure (BP) be measured in both the morning and evening, but few studies of the clinical significance of home BP in the morning versus the evening for target organ damage have been reported.
Methods: In 4,310 patients recruited for the J-HOP (Japan Morning Surge-Home Blood Pressure) study with one or more cardiovascular risk factors, we measured morning and evening home BP during a 14-day period, along with the patients’ urinary albumin creatinine ratio (UACR), brachial-ankle pulse wave velocity (baPWV), left ventricular mass index (LVMI), maximum carotid intima media thickness (IMT), and the levels of N-terminal pro-brain-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (Hs-cTnT).
Results: Both morning and evening SBP levels were significantly associated with all target organ damages (all P<0.001). A comparison of the correlation coefficients from these relationships demonstrates that a more accurate index of baPWV (Z=2.79, P=0.005), NTproBNP (Z=3.60, P<0.001) and Hs-cTnT (Z=3.18, P=0.001) is provided by morning SBP than by evening SBP. In multiple linear regression analysis, morning SBP was independently associated with all indices of target organ damage (TOD), whereas evening SBP was independently associated with TOD (all P<0.001) except for maximum IMT (P=0.069). Evening SBP improved the goodness-of-fit of the association between home SBP and the UACR (P=0.035) and baPWV (P<0.001), but this association was not found in LVMI, maximum IMT, NTproBNP or Hs-cTnT.
Conclusion: Although the clinical indication for morning and evening BP measurements may overlap, the adding of each occasion for the goodness-of-fit of the association between SBP and target organ damage may differ among target organ damage. Morning BP appears to be more closely associated with cardiac/vascular damage than evening BP.
- © 2013 by American Heart Association, Inc.