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Reliability of morning, before-dinner, and at-bedtime home blood pressure measurements in patients with hypertension.

ABSTRACT: The authors evaluated differences in the reliability of home blood pressure measurements taken in the morning, before dinner, and at bedtime. Forty-eight patients with hypertension (age range, 50-89 years; mean age, 76.4 years) measured their home blood pressure using a validated automatic information/communication technology-based device for 14 consecutive days. Those days were divided into the first seven days (1-7) and the following 8 to 14 days (days 8-14) and compared systolic blood pressure (SBP) reliability in the two periods for each measurement time point. In Bland-Altman analyses, morning SBP showed the least standard error of measurement (3.0 mm Hg). There were fixed biases in morning and before-dinner SBP with average limits of agreement of 3.9 and 6.4 mm Hg, respectively. For at-bedtime SBP, a random error was detected and the minimal detectable change was 13.8 mm Hg. The percentage of near-maximal variation of morning SBP was the smallest at 18.1%. Morning SBP therefore provided the most reliable home blood pressure value in the day.

SUBMITTER: Fujiwara T

PROVIDER: S-EPMC8030996 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Difference in evening home blood pressure between before dinner and at bedtime in Japanese elderly hypertensive patients.

Project description:The authors evaluated the differences between evening home blood pressure (HBP) readings taken before dinner and those taken at bedtime, which were documented in a European and a Japanese guideline, respectively. Forty-eight patients (mean age, 76.4 years) measured their evening HBP twice each day (two measurements both before dinner and at bedtime) for 14 days. The authors defined the at-bedtime (B) minus the before-dinner (D) systolic HBP as the B-D difference. The mean B-D difference was -8.7 mm Hg (P<.001). The depressor effect of bathing was significantly prolonged for 120 minutes. The B-D difference with alcohol consumption was significantly greater than that without alcohol. In the linear mixed model analysis, time after bathing ≤120 minutes and alcohol consumption were significantly associated with the B-D difference after adjustment with covariates. There was a marked difference between evening HBP values. When patients' evening HBP is measured according to the guidelines, their daily activities should be considered.

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Home blood pressure measurements for managing hypertension in hemodialysis patients.

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| S-EPMC2786027 | biostudies-literature

Reliability of Office, Home, and Ambulatory Blood Pressure Measurements and Correlation With Left Ventricular Mass.

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| S-EPMC7749264 | biostudies-literature

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Comparison of Office Blood Pressure, Automated Unattended Office Blood Pressure, Home Blood Pressure, and 24-Hour Ambulatory Blood Pressure Measurements

Project description: Not available

| S-EPMC10713445 | biostudies-literature

Characteristics of Individuals with Disagreement between Home and Ambulatory Blood Pressure Measurements for the Diagnosis of Hypertension.

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| S-EPMC7711828 | biostudies-literature

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Project description:To study whether sleep blood pressure (BP) self-measured at home is associated with organ damage, the authors analyzed the data of 2562 participants in the J-HOP study who self-measured sleep BP using a home BP monitoring (HBPM) device, three times during sleep (2 am, 3 am, 4 am), as well as the home morning and evening BPs. The mean sleep home systolic BPs (SBPs) were all correlated with urinary albumin/creatinine ratio (UACR), left ventricular mass index (LVMI), brachial-ankle pulse wave velocity (baPWV), maximum carotid intima-media thickness, and plasma N-terminal pro-hormone pro-brain-type natriuretic peptide (NTproBNP) (all P<.001). After controlling for clinic SBP and home morning and evening SBPs, associations of home sleep SBP with UACR, LVMI, and baPWV remained significant (all P<.008). Even in patients with home morning BP <135/85 mm Hg, 27% exhibited masked nocturnal hypertension with home sleep SBP ≥120 mm Hg and had higher UACR and NTproBNP. Masked nocturnal hypertension, which is associated with advanced organ damage, remains unrecognized by conventional HBPM.

| S-EPMC8031719 | biostudies-literature

Early morning-Best time window of hourly 24-hour ambulatory blood pressure in relation to hypertensive organ damage: The Japan Morning Surge-Home Blood Pressure study.

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| S-EPMC8030499 | biostudies-literature

Comparison of patients' confidence in office, ambulatory, and home blood pressure measurements as methods of assessing for hypertension.

Project description:Uncertainty exists when relying on office (clinic) blood pressure (BP) measurements to diagnose hypertension. Home BP monitoring and ambulatory BP monitoring (ABPM) provide measurements that are more strongly associated with cardiovascular disease. The degree to which patients exhibit uncertainty about office BP measurements is unknown, as is whether they would have less uncertainty about other BP measurement methods. We therefore assessed people's confidence in methods of BP measurement, comparing perceptions about office BP monitoring, home BP monitoring, and ABPM techniques.We surveyed adults who were 30 years or older (n=193), all whom had undergone office BP measurements, two sessions of 24-h ABPM, and two 5-day periods of home BP monitoring. Respondents were asked to indicate their level of confidence on a 1 to 9 scale that BP measurements represented their 'usual' BP.Respondents had least confidence that assessments of BP made by office measurements (median 6) represented usual BP and greater confidence that assessments made by home BP monitoring (median 7, P<0.0001 vs. office) and ABPM (median 8, P<0.0001 vs. office) did so. Confidence levels did not vary significantly by BP levels, age, sex, race, or education level.The finding that patients do not have a great deal of confidence in office BP measurements, but have a higher degree of confidence in home BP and ambulatory BP assessment methods may be helpful in guiding strategies to diagnose hypertension and improve antihypertensive medication adherence.

| S-EPMC4631691 | biostudies-literature

Diagnosing Masked Hypertension Using Ambulatory Blood Pressure Monitoring, Home Blood Pressure Monitoring, or Both?

Project description:Guidelines recommend measuring out-of-clinic blood pressure (BP) to identify masked hypertension (MHT) defined by out-of-clinic BP in the hypertensive range among individuals with clinic-measured BP not in the hypertensive range. The aim of this study was to determine the overlap between ambulatory BP monitoring (ABPM) and home BP monitoring (HBPM) for the detection of MHT. We analyzed data from 333 community-dwelling adults not taking antihypertensive medication with clinic BP <140/90 mm Hg in the IDH study (Improving the Detection of Hypertension). Any MHT was defined by the presence of daytime MHT (mean daytime BP ?135/85 mm Hg), 24-hour MHT (mean 24-hour BP ?130/80 mm Hg), or nighttime MHT (mean nighttime BP ?120/70 mm Hg). Home MHT was defined as mean BP ?135/85 mm Hg on HBPM. The prevalence of MHT was 25.8% for any MHT and 11.1% for home MHT. Among participants with MHT on either ABPM or HBPM, 29.5% had MHT on both ABPM and HBPM; 61.1% had MHT only on ABPM; and 9.4% of participants had MHT only on HBPM. After multivariable adjustment and compared with participants without MHT on ABPM and HBPM, those with MHT on both ABPM and HBPM and only on ABPM had a higher left ventricular mass index (mean difference [SE], 12.7 [2.9] g/m2, P<0.001; and 4.9 [2.1] g/m2, P=0.022, respectively), whereas participants with MHT only on HBPM did not have an increased left ventricular mass index (mean difference [SE], -1.9 [4.8] g/m2, P=0.693). These data suggest that conducting ABPM will detect many individuals with MHT who have an increased cardiovascular disease risk.

| S-EPMC6207212 | biostudies-literature

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