title: Detection of carotid atherosclerosis in individuals with masked hypertension and white-coat hypertension by self-measured blood pressure at home: the Ohasama study.
abstract: OBJECTIVE
  To investigate carotid atherosclerosis in individuals with masked hypertension (MHT) and white-coat hypertension (WCHT) in a general population.
  
  
  METHODS
  Self-measurement of blood pressure at home (HBP) and casual blood pressure (CBP) measurements were recorded in 812 individuals aged at least 55 years (mean 66.4 years) from the general Japanese population. The intima-media thickness (IMT) of the near and far wall of both common carotid arteries was measured and averaged. The relationships between carotid atherosclerosis (IMT and plaque) and the four blood pressure groups (sustained normal blood pressure: HBP < 135/85 mmHg, CBP < 140/90 mmHg; WCHT: HBP < 135/85 mmHg, CBP >or= 140/90 mmHg; MHT: HBP >or= 135/85 mmHg, CBP < 140/90 mmHg; sustained hypertension: HBP >or= 135/85 mmHg, CBP >or= 140/90 mmHg) were examined using multivariate analysis adjusted for possible confounding factors.
  
  
  RESULTS
  Adjusted IMT in individuals with sustained hypertension [0.77 mm; 95% confidence interval (CI) 0.75 to 0.79 mm] and MHT (0.77 mm; 95% CI 0.73 to 0.80 mm) was significantly greater than in those with sustained normal blood pressure (0.71 mm; 95% CI 0.69 to 0.72 mm) and WCHT (0.72 mm; 95% CI 0.71 to 0.74 mm) (P < 0.0001). The odds ratios for the presence of plaques in all four groups were similar to the trends in IMT.
  
  
  CONCLUSIONS
  Our findings imply that CBP measurements alone are insufficient to distinguish individuals at high risk of carotid atherosclerosis from those at low risk. However, these individuals do have distinct HBP measurements, suggesting that HBP measurement could become a valuable tool for predicting carotid atherosclerosis.
authors.affiliation: Department of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Sciences and Medicine, Sendai, Japan.
authors.forename: Azusa
authors.initials: A
authors.lastname: Hara
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Ohkubo
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kikuya
authors.forename: Yoriko
authors.initials: Y
authors.lastname: Shintani
authors.forename: Taku
authors.initials: T
authors.lastname: Obara
authors.forename: Hirohito
authors.initials: H
authors.lastname: Metoki
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Inoue
authors.forename: Kei
authors.initials: K
authors.lastname: Asayama
authors.forename: Takanao
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Toshiya
authors.initials: T
authors.lastname: Harasawa
authors.forename: Yoko
authors.initials: Y
authors.lastname: Aono
authors.forename: Harunori
authors.initials: H
authors.lastname: Otani
authors.forename: Kazushi
authors.initials: K
authors.lastname: Tanaka
authors.forename: Junichiro
authors.initials: J
authors.lastname: Hashimoto
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Totsune
authors.forename: Haruhisa
authors.initials: H
authors.lastname: Hoshi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Satoh
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Imai
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D018660:Blood Pressure Monitoring, Ambulatory; D015992:Body Mass Index; D002340:Carotid Artery Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis*; D008403:Mass Screening; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D018570:Risk Assessment