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Association of night-time home blood pressure with night-time ambulatory blood pressure and target-organ damage: a systematic review and meta-analysis

Kollias, Anastasios; Ntineri, Angeliki; Stergiou, George S.

doi: 10.1097/HJH.0000000000001189
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Objective: Night-time ambulatory blood pressure (nABP) is the most important aspect of the blood pressure profile in terms of prognosis. Novel low-cost home monitors allow automated night-time blood pressure monitoring (nHBP). This study reviewed the evidence on the association of nHBP with nABP and preclinical organ damage.

Methods: Systematic review and meta-analysis.

Results: Analysis of six studies (n = 1404) showed pooled difference between nHBP and nABP (SBP/DBP) at 1.4, 95% confidence interval (CI) 0.3, 2.6/−0.2, 95% CI −0.9, 0.6 mmHg, whereas the pooled correlation coefficient between nHBP and nABP (SBP/DBP) was r = 0.70, 95% CI 0.59, 0.81/r = 0.72, 95% CI 0.67, 0.77, respectively. Two studies (n = 212) investigated the agreement between nHBP and nABP in detecting nondippers with weighted agreement 77.3% (pooled kappa 0.27, 95% CI 0.08, 0.45). Three studies (n = 954) reported on the association of left ventricular mass index with systolic nHBP and nABP (pooled correlation coefficient r = 0.36, 95% CI 0.23, 0.50 and r = 0.32, 95% CI 0.10, 0.54, respectively, P = NS for comparison). Two studies (n = 950) reported on the association of urinary albumin excretion with systolic nHBP and nABP (pooled r = 0.39, 95% CI 0.21, 0.58 and r = 0.30, 95% CI 0.06, 0.55, respectively, P < 0.01 for comparison). Two studies (n = 350) reported on the association of common carotid intima–media thickness with systolic nHBP and nABP (pooled r = 0.31, 95% CI 0.16, 0.46 and r = 0.35, 95% CI 0.17, 0.53, respectively, P = NS for comparison).

Conclusion: The available evidence suggests that nHBP and nABP present similar values and comparable relationship with target-organ damage. Studies on the prognostic value of nHBP are needed.

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Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Athens, Greece

Correspondence to Prof George S. Stergiou, MD, FRCP, Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, 152 Mesogion Avenue, Athens 11527, Greece. Tel: +30 2107763117; fax: +30 2107719981; e-mail: stergiougs@gmail.com

Abbreviations: BP, blood pressure; CI, confidence interval; nABP, night-time ambulatory blood pressure; nHBP, night-time home blood pressure

Received 15 July, 2016

Revised 25 September, 2016

Accepted 24 October, 2016

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