Influence of home blood pressure measuring conditions in the evening on the morning-evening home blood pressure difference in treated hypertensive patients: the J-HOME study.
OBJECTIVE
The objective of this study was to clarify the factors affecting the morning-evening home systolic blood pressure (BP) difference (home systolic ME dif) in treated hypertensive patients, including evening home BP measuring conditions, based on the data from the Japan Home versus Office BP Measurement Evaluation study.


METHODS
The study participants were 3303 essential hypertensive patients (mean age 66.2+/-10.5 years; females 55.3%) treated using antihypertensive drug therapy in primary care settings in Japan. Multivariate regression analysis including the variables that were significantly associated with the home systolic ME dif on the univariate analysis was performed.


RESULTS
The mean of the home systolic/diastolic ME dif was 6.1+/-10.8/4.8+/-6.5 mmHg. The proportion of patients measuring evening BP after drinking alcohol was 20.5%, and the proportion of patients measuring evening BP after bathing was 76.8%. Uncontrolled morning systolic BP (morning systolic BP > or =135 mmHg), controlled evening systolic BP (evening systolic BP <135 mmHg), older age (> or =65 years), measurement of evening BP after drinking, and measurement of evening BP after bathing were positively associated with the home systolic ME dif on multivariate regression analysis.


CONCLUSIONS
Measurement of evening BP after drinking and measurement of evening BP after bathing were strongly associated with an increased home systolic ME dif, independent of morning and evening home BP levels. Therefore, evening home BP measuring conditions (before or after drinking alcohol and bathing) should be taken into account while evaluating the home systolic ME dif.
Ito
Kie
K
Department of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Sciences and Medicine, Sendai, Japan.
Obara
Taku
T
Ohkubo
Takayoshi
T
Gonokami
Kenta
K
Shinki
Takahiro
T
Shibamiya
Taku
T
Nakashita
Manami
M
Kobayashi
Mitsuru
M
Funahashi
Jin
J
Hara
Azusa
A
Metoki
Hirohito
H
Asayama
Kei
K
Inoue
Ryusuke
R
Kikuya
Masahiro
M
Mano
Nariyasu
N
Imai
Yutaka
Y
D000368:Aged; D000428:Alcohol Drinking; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001494:Baths; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D002940:Circadian Rhythm / Q000502:physiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology*; D007564:Japan; D008297:Male; D015999:Multivariate Analysis; D012044:Regression Analysis; D013997:Time Factors
D000959:Antihypertensive Agents