title: Association of home and ambulatory blood pressure changes with changes in cardiovascular biomarkers during antihypertensive treatment.
abstract: BACKGROUND
  Our aim was to assess whether home blood pressure (HBP) and ambulatory BP monitoring measurement (ABPM), in addition to office BP (OBP) predict changes of cardiovascular biomarkers during antihypertensive treatment.
  
  
  METHODS
  Two hundred and fifty-two hypertensive patients (mean age, 68 years; men: 41%) underwent measurements of OBP, HBP, ABPM, and cardiovascular biomarkers (urinary albumin excretion (UAE) and brain natriuretic peptide (BNP)) before and after 6 months of treatment with candesartan (± thiazide-diuretics).
  
  
  RESULTS
  During the intervention, the OBP, HBP, daytime and night-time BP, and UAE levels were all significantly reduced (all P < 0.01). BNP was reduced only in the patients using diuretics (P = 0.003). For predicting the treatment-induced change in UAE, each of home systolic BP (SBP) and night-time SBP changes, but not daytime SBP change, had independent and significant value beyond OBP measurement (both P < 0.05). In contrast, for predicting the treatment-induced change in BNP, night-time SBP changes, but not home or daytime SBP changes, had significant value beyond OBP measurement (both P < 0.05). Patients who achieved a reduction in all three SBP parameters (office, home, and night-time SBP; n = 122) showed a more significant reduction of UAE compared with those who did not (-52.6 vs. -32.5%; P = 0.001), and patients who achieved a reduction in both office and night-time SBP (n = 134) showed a more significant reductions of BNP than those who did not (-12.9 vs. +12.8%; P < 0.05).
  
  
  CONCLUSIONS
  HBP and ABPM measurements, particularly night-time SBP values provide additional information for predicting treatment-induced changes of cardiovascular biomarkers when used in conjunction with office SBP measurement during antihypertensive treatment.
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
authors.forename: Yuichirou
authors.initials: Y
authors.lastname: Yano
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hoshide
authors.forename: Motohiro
authors.initials: M
authors.lastname: Shimizu
authors.forename: Kazuo
authors.initials: K
authors.lastname: Eguchi
authors.forename: Joji
authors.initials: J
authors.lastname: Ishikawa
authors.forename: Shizukiyo
authors.initials: S
authors.lastname: Ishikawa
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Shimada
authors.forename: Kazuomi
authors.initials: K
authors.lastname: Kario
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria; D000959:Antihypertensive Agents / Q000627:therapeutic use; D015415:Biomarkers; D001794:Blood Pressure / Q000187:drug effects*; D001795:Blood Pressure Determination / Q000706:statistics & numerical data*; D018660:Blood Pressure Monitoring, Ambulatory / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000188:drug therapy / Q000652:urine*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D016032:Randomized Controlled Trials as Topic
chemical_list: D000959:Antihypertensive Agents; D015415:Biomarkers; D020097:Natriuretic Peptide, Brain