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Journal of Hypertension:
doi: 10.1097/HJH.0b013e328365c8a8
ORIGINAL PAPERS: BP measurement

Assessment of the reductions in night-time blood pressure and dipping induced by antihypertensive medication using a home blood pressure monitor

Ishikawa, Joji; Shimizu, Motohiro; Sugiyama Edison, Eijiro; Yano, Yuichiro; Hoshide, Satoshi; Eguchi, Kauzo; Kario, Kazuomi; J-TOP (Japan Morning Surge-Target Organ Protection) Study Investigators Group

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Abstract

Background: Night-time blood pressure (BP) is strongly associated with hypertensive target organ damage; however, no previous studies have compared home BP monitor measurements of the reduction in night-time BP induced by antihypertensive medications with those obtained with ambulatory BP monitors.

Methods: As part of the Japan Morning Surge-Target Organ Protection study, in which candesartan (thiazide diuretics were added, if needed) was administered to hypertensive patients in the morning or at bedtime, 50 hypertensive patients had their night-time home and ambulatory BP successfully measured at the baseline and 6 months. In addition, three night-time home BP readings were taken during sleeping hours (at 2, 3, and 4 o’clock) for 6 months.

Results: The mean reduction in night-time BP did not differ significantly between home and ambulatory BP monitoring (10.4 ± 17.9/6.0 ± 12.0 vs. 13.3 ± 14.6/7.6 ± 8.9 mmHg, P = 0.219/0.344), but the differences varied among individual patients. The reduction in night-time BP according to home BP monitoring was significantly correlated with the value obtained with ambulatory BP monitoring (r = 0.51/0.38, P < 0.001/=0.006). The reduction in night-time SBP according to home BP monitoring was significantly correlated with the reductions in left ventricular mass index (r = 0.385, P = 0.013, N = 41) and Sokolow–Lyon voltage (r = 0.335, P = 0.035, N = 40).

Conclusion: Home BP monitoring produces estimates of mean night-time BP reductions comparable to those from ambulatory monitoring, while the differences varied among individual patients. The reduction in night-time home BP according to home BP monitoring is significantly correlated with the reduction in left ventricular hypertrophy.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

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