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The association between home vs. ambulatory night-time blood pressure and end-organ damage in the general population

Lindroos, Annika S.a,b,d; Johansson, Jouni K.b; Puukka, Pauli J.b; Kantola, Ilkkaa,d; Salomaa, Veikkoc; Juhanoja, Eeva P.a,b,d; Sivén, Sam S.E.a,b,d; Jousilahti, Pekkac; Jula, Antti M.b,d; Niiranen, Teemu J.b,e

doi: 10.1097/HJH.0000000000000995
ORIGINAL PAPERS: BP measurement
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Objective: The aim of this study was to test the agreement between night-time home and night-time ambulatory blood pressure (BP) and to compare their associations with hypertensive end-organ damage for the first time in the general population.

Methods: A population sample of 248 participants underwent measurements for night-time home BP (three measurements on two nights with a timer-equipped home device), night-time ambulatory BP, pulse wave velocity (PWV), carotid intima–media thickness (IMT) and echocardiographic left ventricular mass index (LVMI).

Results: No significant or systematic differences were observed between mean night-time ambulatory and home BPs (systolic/diastolic difference: 0.7 ± 7.6/0.2 ± 6.0 mmHg, P = 0.16/0.64). All night-time home and ambulatory BPs were positively correlated with PWV, IMT and LVMI (P < 0.01 for all). No significant differences in Pearson's correlations between end-organ damage and night-time home or ambulatory BP were observed (P ≥ 0.11 for all comparisons using Dunn and Clark's Z), except for a slightly stronger correlation between PWV and ambulatory SBP than for home SBP (r = 0.57 vs. 0.50, P = 0.03). The adjusted R2 of all multivariable-adjusted models for PWV, IMT or LVMI that included night-time home or ambulatory SBP/DBP were within 2/1%.

Conclusion: Our study demonstrates that night-time home and ambulatory measurements produce similar BP values that have comparable associations with end-organ damage in the general population even when a clinically feasible measurement protocol is used for measuring night-time home BP. In the future, night-time home BP measurement may offer a feasible and easily accessible alternative to ambulatory monitoring for the measurement of night-time BP.

aDivision of Medicine, Turku University Hospital

bDepartment of Health, National Institute for Health and Welfare, Turku

cDepartment of Health, National Institute for Health and Welfare, Helsinki

dDepartment of Medicine, University of Turku, Turku, Finland

eThe Framingham Heart Study, Framingham, Massachusetts, USA

Correspondence to Annika S. Lindroos, MD, Department of Health, National Institute for Health and Welfare, Kiinamyllynkatu 13, PO Box 57, FI-20521 Turku, Finland. Tel: +358 50 5648285; fax: +358 2 3316720; e-mail: ansoli@utu.fi

Abbreviations: ABP, ambulatory blood pressure; BP, blood pressure; HBP, home blood pressure; IMT, intima–media thickness; LVM, left ventricular mass; LVMI, left ventricular mass index; MI, myocardial infarction; PWV, pulse wave velocity

Received 18 February, 2016

Revised 3 May, 2016

Accepted 9 May, 2016

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