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.
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.
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).
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.
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Division of Cardiovascular Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan
Correspondence to Kazuomi Kario, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan. Tel: +81 285587344; fax: +81 285442132; e-mail: email@example.com
Abbreviations: BP, blood pressure; IVSTD, diastolic interventricular septal diameter; J-TOP Study, Japan Morning Surge-Target Organ Protection Study; LVIDD, diastolic left ventricular dimension; LVM, left ventricular mass; LVMI, left ventricular mass index; PWTD, diastolic posterior wall diameter; SAMPLE Study, Study on Ambulatory Monitoring of Blood Pressure and Lisinopril Evaluation Study
Received 22 June, 2013
Revised 7 August, 2013
Accepted 13 August, 2013
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