Morning and Evening Home Blood Pressure and Risks of Incident Stroke and Coronary Artery Disease in the Japanese General Practice Population

Autor: Akira Nakamura, Kayo Yamagiwa, Satoshi Hoshide, Kiyoshi Uchiba, Kazuomi Kario, Yuichiro Yano, Kazuo Eguchi, Shoichiro Nagasaka, Hajime Haimoto, Yoshio Matsui, Motoki Fukutomi, Joji Ishikawa
Rok vydání: 2016
Předmět:
Male
medicine.medical_specialty
Evening
Databases
Factual
General Practice
Population
Coronary Artery Disease
030204 cardiovascular system & hematology
Severity of Illness Index
Cohort Studies
Coronary artery disease
03 medical and health sciences
Age Distribution
0302 clinical medicine
Japan
Risk Factors
Internal medicine
Confidence Intervals
Internal Medicine
medicine
Humans
030212 general & internal medicine
Sex Distribution
Intensive care medicine
education
Stroke
Antihypertensive Agents
Aged
Proportional Hazards Models
Retrospective Studies
Morning
education.field_of_study
business.industry
Blood Pressure Determination
Blood Pressure Monitoring
Ambulatory
Middle Aged
medicine.disease
Confidence interval
Circadian Rhythm
Survival Rate
Blood pressure
Hypertension
Cardiology
Female
business
Cohort study
Zdroj: Hypertension. 68:54-61
ISSN: 1524-4563
0194-911X
Popis: Our aim is to determine the optimal time schedule for home blood pressure (BP) monitoring that best predicts stroke and coronary artery disease in general practice. The Japan Morning Surge-Home Blood Pressure (J-HOP) study is a nationwide practice-based study that included 4310 Japanese with a history of or risk factors for cardiovascular disease, or both (mean age, 65 years; 79% used antihypertensive medication). Home BP measures were taken twice daily (morning and evening) over 14 days at baseline. During a mean follow-up of 4 years (16 929 person-years), 74 stroke and 77 coronary artery disease events occurred. Morning systolic BP (SBP) improved the discrimination of incident stroke ( C statistics, 0.802; 95% confidence interval, 0.692–0.911) beyond traditional risk factors including office SBP (0.756; 0.646–0.866), whereas the changes were smaller with evening SBP (0.764; 0.653–0.874). The addition of evening SBP to the model (including traditional risk factors plus morning SBP) significantly reduced the discrimination of incident stroke ( C statistics difference, −0.008; 95% confidence interval: −0.015 to −0.008; P =0.03). The category-free net reclassification improvement (0.3606; 95% confidence interval, 0.1317–0.5896), absolute integrated discrimination improvement (0.015; SE, 0.005), and relative integrated discrimination improvement (58.3%; all P Clinical Trial Registration— URL: http://www.umin.ac.jp/ctr/ . Unique identifier: UMIN000000894.
Databáze: OpenAIRE
Externí odkaz: