Abstract:
Background: Nocturnal home blood pressure monitoring (HBPM) may identify people at higher cardiovascular disease (CVD) risk than expected.
Objectives: To examine the association between office-masked nocturnal hypertension, defined by HBPM, and CVD risk in a clinical practice-based population.
Methods: Prospective observational study including Japanese high cardiovascular-risk participants. Three office BPs (OBPs) were taken on two different occasions. Nocturnal HBP was measured three times per night for two weeks. The association between office-masked nocturnal hypertension and time to first CVD events (fatal and non-fatal stroke or coronary heart disease) was examined using Cox regression.
Results: Cohort included 2,545 participants were followed for a median of 7.8 years (18,116 person-years), during which 152 CVD events occurred. The proportions of participants with nocturnal normotension (OBP<140/90 mmHg and nocturnal HBP<120/70 mmHg), white-coat nocturnal hypertension (OBP≥140/90 mmHg and nocturnal HBP<120/70 mmHg), office-masked nocturnal hypertension (OBP<140/90 mmHg and nocturnal HBP≥120/70 mmHg), and sustained nocturnal hypertension (OBP≥140/90 mmHg and nocturnal HBP≥120/70 mmHg) were 25.3%, 14.4%, 23.2%, and 37.1%, respectively. Relative to nocturnal normotension, those with both office-masked nocturnal hypertension (adjusted hazard ratio [aHR] 1.72, 95% confidence interval [CI] 1.01-2.92) and sustained nocturnal hypertension (aHR 1.75, 95%CI 1.03-2.96) had similarly increased CVD risk, even after adjustment for daytime HBP values.
Conclusions: Screening for office-masked nocturnal hypertension with HBPM identifies a potentially important group of patients with increased risk for incident CVD events for whom additional preventative measures may be appropriate.
JACC: Advances Editor-in-Chief
Candice K. Silversides, MD, FACC
JACC: Advances CME Editor
Kenneth A. Ellenbogen, MD
Author
Nikhil Narang, MD, FACC
Important Dates
Date of Release: November 27, 2024
Term of Approval/Date of CME/MOC Expiration: November 26, 2025