Association between amplitude of seasonal variation in self-measured home blood pressure and cardiovascular outcomes: HOMED-BP (Hypertension Objective Treatment Based on Measurement by Electrical Devices of Blood Pressure) study

On behalf of the HOMED-BP (Hypertension Objective Treatment Based on Measurement by Electrical Devices of Blood Pressure) Investigators

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background--The clinical significance of long-term seasonal variations in self-measured home blood pressure (BP) has not been elucidated for the cardiovascular disease prevention. Methods and Results--Eligible 2787 patients were classified into 4 groups according to the magnitude of their seasonal variation in home BP, defined as an average of all increases in home BP from summer (July-August) to winter (January- February) combined with all decreases from winter to summer throughout the follow-up period, namely inverse- (systolic/ diastolic, < 0/< 0 mm Hg), small- (0-4.8/0-2.4 mm Hg), middle- (4.8-9.1/2.4-4.5 mm Hg), or large- (≥9.1/≥4.5 mm Hg) variation groups. The overall cardiovascular risks illustrated U-shaped relationships across the groups, and hazard ratios for all cardiovascular outcomes compared with the small-variation group were 3.07 (P=0.004) and 2.02 (P=0.041) in the inversevariation group and large-variation group, respectively, based on systolic BP, and results were confirmatory for major adverse cardiovascular events. Furthermore, when the summer-winter home BP difference was evaluated among patients who experienced titration and tapering of antihypertensive drugs depending on the season, the difference was significantly smaller in the early (September-November) than in the late (December-February) titration group (3.9/1.2 mm Hg versus 7.3/ 3.1 mm Hg, P < 0.001) as well as in the early (March-May) than in the late (June-August) tapering group (4.4/2.1 mm Hg versus 7.1/3.4 mm Hg, P < 0.001). Conclusions--The small-to-middle seasonal variation in home BP (0-9.1/0-4.5 mm Hg), which may be partially attributed to earlier adjustment of antihypertensive medication, were associated with better cardiovascular outcomes.

Original languageEnglish
Article numbere008509
JournalJournal of the American Heart Association
Volume7
Issue number10
DOIs
Publication statusPublished - May 15 2018

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Blood Pressure
Hypertension
Equipment and Supplies
Antihypertensive Agents
Therapeutics
Cardiovascular Diseases

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Association between amplitude of seasonal variation in self-measured home blood pressure and cardiovascular outcomes : HOMED-BP (Hypertension Objective Treatment Based on Measurement by Electrical Devices of Blood Pressure) study. / On behalf of the HOMED-BP (Hypertension Objective Treatment Based on Measurement by Electrical Devices of Blood Pressure) Investigators.

In: Journal of the American Heart Association, Vol. 7, No. 10, e008509, 15.05.2018.

Research output: Contribution to journalArticle

@article{201d474fd19f4814ba4e6b0de5132e9e,
title = "Association between amplitude of seasonal variation in self-measured home blood pressure and cardiovascular outcomes: HOMED-BP (Hypertension Objective Treatment Based on Measurement by Electrical Devices of Blood Pressure) study",
abstract = "Background--The clinical significance of long-term seasonal variations in self-measured home blood pressure (BP) has not been elucidated for the cardiovascular disease prevention. Methods and Results--Eligible 2787 patients were classified into 4 groups according to the magnitude of their seasonal variation in home BP, defined as an average of all increases in home BP from summer (July-August) to winter (January- February) combined with all decreases from winter to summer throughout the follow-up period, namely inverse- (systolic/ diastolic, < 0/< 0 mm Hg), small- (0-4.8/0-2.4 mm Hg), middle- (4.8-9.1/2.4-4.5 mm Hg), or large- (≥9.1/≥4.5 mm Hg) variation groups. The overall cardiovascular risks illustrated U-shaped relationships across the groups, and hazard ratios for all cardiovascular outcomes compared with the small-variation group were 3.07 (P=0.004) and 2.02 (P=0.041) in the inversevariation group and large-variation group, respectively, based on systolic BP, and results were confirmatory for major adverse cardiovascular events. Furthermore, when the summer-winter home BP difference was evaluated among patients who experienced titration and tapering of antihypertensive drugs depending on the season, the difference was significantly smaller in the early (September-November) than in the late (December-February) titration group (3.9/1.2 mm Hg versus 7.3/ 3.1 mm Hg, P < 0.001) as well as in the early (March-May) than in the late (June-August) tapering group (4.4/2.1 mm Hg versus 7.1/3.4 mm Hg, P < 0.001). Conclusions--The small-to-middle seasonal variation in home BP (0-9.1/0-4.5 mm Hg), which may be partially attributed to earlier adjustment of antihypertensive medication, were associated with better cardiovascular outcomes.",
author = "{On behalf of the HOMED-BP (Hypertension Objective Treatment Based on Measurement by Electrical Devices of Blood Pressure) Investigators} and Tomohiro Hanazawa and Kei Asayama and Daisuke Watabe and Ayumi Tanabe and Michihiro Satoh and Ryusuke Inoue and Azusa Hara and Taku Obara and Masahiro Kikuya and Kyoko Nomura and Hirohito Metoki and Yutaka Imai and Takayoshi Ohkubo and K. Arakawa and M. Fujishima and J. Fujii and K. Fukiyama and S. Hisamichi and O. Iimura and M. Ishii and T. Omae and T. Saruta and K. Yoshinaga and I. Abe and K. Abe and T. Abukawa and T. Ashida and N. Dohba and T. Etoh and A. Fujimura and T. Fujita and A. Fukui and T. Gotoh and H. Hama and T. Hano and H. Hayashi and N. Hayashida and M. Hayashi and K. Hiramori and Y. Hirai and Y. Hirata and K. Hiwada and K. Hora and S. Ichikawa and T. Iida and T. Ikeda and T. Imaizumi and K. Ishikawa and I. Ito and Takeo Fujino",
year = "2018",
month = "5",
day = "15",
doi = "10.1161/JAHA.117.008509",
language = "English",
volume = "7",
journal = "Journal of the American Heart Association",
issn = "2047-9980",
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TY - JOUR

T1 - Association between amplitude of seasonal variation in self-measured home blood pressure and cardiovascular outcomes

T2 - HOMED-BP (Hypertension Objective Treatment Based on Measurement by Electrical Devices of Blood Pressure) study

AU - On behalf of the HOMED-BP (Hypertension Objective Treatment Based on Measurement by Electrical Devices of Blood Pressure) Investigators

AU - Hanazawa, Tomohiro

AU - Asayama, Kei

AU - Watabe, Daisuke

AU - Tanabe, Ayumi

AU - Satoh, Michihiro

AU - Inoue, Ryusuke

AU - Hara, Azusa

AU - Obara, Taku

AU - Kikuya, Masahiro

AU - Nomura, Kyoko

AU - Metoki, Hirohito

AU - Imai, Yutaka

AU - Ohkubo, Takayoshi

AU - Arakawa, K.

AU - Fujishima, M.

AU - Fujii, J.

AU - Fukiyama, K.

AU - Hisamichi, S.

AU - Iimura, O.

AU - Ishii, M.

AU - Omae, T.

AU - Saruta, T.

AU - Yoshinaga, K.

AU - Abe, I.

AU - Abe, K.

AU - Abukawa, T.

AU - Ashida, T.

AU - Dohba, N.

AU - Etoh, T.

AU - Fujimura, A.

AU - Fujita, T.

AU - Fukui, A.

AU - Gotoh, T.

AU - Hama, H.

AU - Hano, T.

AU - Hayashi, H.

AU - Hayashida, N.

AU - Hayashi, M.

AU - Hiramori, K.

AU - Hirai, Y.

AU - Hirata, Y.

AU - Hiwada, K.

AU - Hora, K.

AU - Ichikawa, S.

AU - Iida, T.

AU - Ikeda, T.

AU - Imaizumi, T.

AU - Ishikawa, K.

AU - Ito, I.

AU - Fujino, Takeo

PY - 2018/5/15

Y1 - 2018/5/15

N2 - Background--The clinical significance of long-term seasonal variations in self-measured home blood pressure (BP) has not been elucidated for the cardiovascular disease prevention. Methods and Results--Eligible 2787 patients were classified into 4 groups according to the magnitude of their seasonal variation in home BP, defined as an average of all increases in home BP from summer (July-August) to winter (January- February) combined with all decreases from winter to summer throughout the follow-up period, namely inverse- (systolic/ diastolic, < 0/< 0 mm Hg), small- (0-4.8/0-2.4 mm Hg), middle- (4.8-9.1/2.4-4.5 mm Hg), or large- (≥9.1/≥4.5 mm Hg) variation groups. The overall cardiovascular risks illustrated U-shaped relationships across the groups, and hazard ratios for all cardiovascular outcomes compared with the small-variation group were 3.07 (P=0.004) and 2.02 (P=0.041) in the inversevariation group and large-variation group, respectively, based on systolic BP, and results were confirmatory for major adverse cardiovascular events. Furthermore, when the summer-winter home BP difference was evaluated among patients who experienced titration and tapering of antihypertensive drugs depending on the season, the difference was significantly smaller in the early (September-November) than in the late (December-February) titration group (3.9/1.2 mm Hg versus 7.3/ 3.1 mm Hg, P < 0.001) as well as in the early (March-May) than in the late (June-August) tapering group (4.4/2.1 mm Hg versus 7.1/3.4 mm Hg, P < 0.001). Conclusions--The small-to-middle seasonal variation in home BP (0-9.1/0-4.5 mm Hg), which may be partially attributed to earlier adjustment of antihypertensive medication, were associated with better cardiovascular outcomes.

AB - Background--The clinical significance of long-term seasonal variations in self-measured home blood pressure (BP) has not been elucidated for the cardiovascular disease prevention. Methods and Results--Eligible 2787 patients were classified into 4 groups according to the magnitude of their seasonal variation in home BP, defined as an average of all increases in home BP from summer (July-August) to winter (January- February) combined with all decreases from winter to summer throughout the follow-up period, namely inverse- (systolic/ diastolic, < 0/< 0 mm Hg), small- (0-4.8/0-2.4 mm Hg), middle- (4.8-9.1/2.4-4.5 mm Hg), or large- (≥9.1/≥4.5 mm Hg) variation groups. The overall cardiovascular risks illustrated U-shaped relationships across the groups, and hazard ratios for all cardiovascular outcomes compared with the small-variation group were 3.07 (P=0.004) and 2.02 (P=0.041) in the inversevariation group and large-variation group, respectively, based on systolic BP, and results were confirmatory for major adverse cardiovascular events. Furthermore, when the summer-winter home BP difference was evaluated among patients who experienced titration and tapering of antihypertensive drugs depending on the season, the difference was significantly smaller in the early (September-November) than in the late (December-February) titration group (3.9/1.2 mm Hg versus 7.3/ 3.1 mm Hg, P < 0.001) as well as in the early (March-May) than in the late (June-August) tapering group (4.4/2.1 mm Hg versus 7.1/3.4 mm Hg, P < 0.001). Conclusions--The small-to-middle seasonal variation in home BP (0-9.1/0-4.5 mm Hg), which may be partially attributed to earlier adjustment of antihypertensive medication, were associated with better cardiovascular outcomes.

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U2 - 10.1161/JAHA.117.008509

DO - 10.1161/JAHA.117.008509

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C2 - 29728372

AN - SCOPUS:85046939638

VL - 7

JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

SN - 2047-9980

IS - 10

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