title: Ambulatory versus home versus clinic blood pressure: the association with subclinical cerebrovascular diseases: the Ohasama Study.
abstract: The usefulness of ambulatory, home, and casual/clinic blood pressure measurements to predict subclinical cerebrovascular diseases (silent cerebrovascular lesions and carotid atherosclerosis) was compared in a general population. Data on ambulatory, home, and casual/clinic blood pressures and brain MRI to detect silent cerebrovascular lesions were obtained in 1007 subjects aged ≥55 years in a general population of Ohasama, Japan. Of the 1007 subjects, 583 underwent evaluation of the extent of carotid atherosclerosis. Twenty-four-hour, daytime, and nighttime ambulatory and home blood pressure levels were closely associated with the risk of silent cerebrovascular lesions and carotid atherosclerosis (all P<0.05). When home and one of the ambulatory blood pressure values were simultaneously included in the same regression model, each of the ambulatory blood pressure values remained a significant predictor of silent cerebrovascular lesions, whereas home blood pressure lost its predictive value. Of the ambulatory blood pressure values, nighttime blood pressure was the strongest predictor of silent cerebrovascular lesions. The home blood pressure value was more closely associated with the risk of carotid atherosclerosis than any of the ambulatory blood pressure values when home and one of the ambulatory blood pressure values were simultaneously included in the same regression model. The casual/clinic blood pressure value had no significant association with the risk of subclinical cerebrovascular diseases. Although the clinical indications for ambulatory blood pressure monitoring and home blood pressure measurements may overlap, the clinical significance of each method for predicting target organ damage may differ for different target organs.
authors.affiliation: Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.
authors.forename: Azusa
authors.initials: A
authors.lastname: Hara
authors.forename: Kazushi
authors.initials: K
authors.lastname: Tanaka
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Ohkubo
authors.forename: Takeo
authors.initials: T
authors.lastname: Kondo
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kikuya
authors.forename: Hirohito
authors.initials: H
authors.lastname: Metoki
authors.forename: Takanao
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Michihiro
authors.initials: M
authors.lastname: Satoh
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Inoue
authors.forename: Kei
authors.initials: K
authors.lastname: Asayama
authors.forename: Taku
authors.initials: T
authors.lastname: Obara
authors.forename: Takuo
authors.initials: T
authors.lastname: Hirose
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Izumi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Satoh
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Imai
mesh_terms: D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data*; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory / Q000706:statistics & numerical data*; D002340:Carotid Artery Diseases / Q000208:ethnology*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010824:Physicians' Offices / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D059466:White Coat Hypertension / Q000175:diagnosis* / Q000208:ethnology*