Cardiovascular Events Risk in Office-Masked Nocturnal Hypertension Defined by Home Blood Pressure Monitoring (JACC: Advances November 2024)-Article: Cardiovascular Events Risk in Office-Masked Nocturnal Hypertension Defined by Home Blood Pressure Monitoring

Article: Cardiovascular Events Risk in Office-Masked Nocturnal Hypertension Defined by Home Blood Pressure Monitoring

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The study investigated the link between office-masked nocturnal hypertension (high blood pressure during sleep undetected in office settings) identified through home blood pressure monitoring (HBPM) and cardiovascular disease (CVD) risk. Conducted with 2,545 Japanese participants at high cardiovascular risk, the prospective study found that participants with office-masked nocturnal hypertension were at a higher risk for CVD events compared to those with normal nocturnal blood pressure. Over a median follow-up of 7.8 years, participants with this condition had a similar increase in CVD risk as those with sustained nocturnal hypertension, even after accounting for daytime home blood pressure.<br /><br />The study underscores the importance of nocturnal blood pressure monitoring in identifying patients at elevated cardiovascular risk, complementing traditional daytime measurements. The findings suggest that integrating nocturnal HBPM in clinical practice could enhance CVD risk stratification and management. The results also emphasize the potential for nocturnal blood pressure measurements to reveal risks missed by office BP monitoring, which often portrays a controlled state in patients who, in fact, have elevated night-time pressures.<br /><br />The study's strengths include its comprehensive scope and reliable methodology, using consistent devices for blood pressure monitoring. However, limitations include a high prevalence of participants on antihypertensive medications and a focus on a high-risk Japanese population, possibly limiting the generalizability of findings.<br /><br />Overall, the study advocates for considering nocturnal blood pressure in CVD risk assessment and encourages further research to evaluate the benefits of managing nocturnal hypertension to prevent cardiovascular events.

Keywords

nocturnal hypertension

cardiovascular disease

home blood pressure monitoring

CVD risk

office-masked hypertension

Japanese participants

blood pressure monitoring

antihypertensive medications

risk stratification

clinical practice