Home blood pressure (BP) has been a stronger association with cardiovascular disease risk than clinic BP. However, the data are sparse about the impact of home BP for cardiovascular outcome in very elderly clinical population.
We assessed the data from the J-HOP (Japan Morning Surge-Home Blood Pressure) study, which was a nationwide practice-based study that included 4,310 Japanese with a history of and/or risk factors for cardiovascular disease. A total of 4,310 patients, 349 of whom were aged >80 years, were analyzed. Home BP measures were taken twice daily (morning and evening) over 14 days at baseline.
Average age was 82.8 years (range 80–96 years). Average morning and evening BP levels were 146 ± 19/73 ± 10mmHg and 134 ± 17/68 ± 9.8mmHg, respectively. Twenty-two cardiovascular events (sudden death, fatal and nonfatal stroke, angina pectoris requiring coronary intervention, and acute myocardial infarction) occurred during follow-up (1205 person-years). Cox hazard analysis showed that morning systolic BP (SBP) increase was associated with cardiovascular events after adjusted for age, gender, body mass index, total-cholesterol, high-density-lipoprotein cholesterol, diabetes, past history of cardiovascular disease, use of antihypertensive drug and statin, and clinic SBP (Hazard ratio [HR] per 1SD, 1.68; 95% confidence interval [CI], 1.08–2.63; P = 0.021), while this association was not found in evening SBP (HR per 1SD, 1.52; 95%CI, [0.94–2.45]; P = 0.085). Both morning and evening diastolic BP was not associated with cardiovascular events.
Morning home SBP was associated with cardiovascular ev ± ents in very elderly clinical population.
Jichi Medical University School of Medicine, Shimotsuke, Japan