Association of morning and evening blood pressure at home with asymptomatic organ damage in the J-HOP Study.
BACKGROUND
Several guidelines recommend that home blood pressure (HBP) be measured both in the morning and in the evening. However, there have been fewer reports about the clinical significance of morning HBP than about the clinical significance of evening HBP.


METHODS
Our study included 4,310 patients recruited for the Japan Morning Surge Home Blood Pressure Study who had one or more cardiovascular risk factors. We measured morning and evening HBP, urinary albumin-creatinine ratio (UACR), left ventricular mass index (LVMI), brachial-ankle pulse wave velocity (baPWV), maximum carotid intima media thickness (IMT), N-terminal pro-brain-type natriuretic peptide (NT-proBNP), and high-sensitivity cardiac troponin T (Hs-cTnT).


RESULTS
The correlation coefficients for the associations between morning systolic BP (SBP) and log-transformed baPWV, NT-proBNP, or Hs-cTnT were significantly greater than the corresponding relationships for evening SBP (all P < 0.01). The goodness-of-fit of the associations between morning home SBP and UACR (P < 0.05) or baPWV (P < 0.01) was improved by adding evening home SBP to the SBP measurement. In contrast, the goodness-of-fit values of the associations between evening SBP and UACR (P < 0.001), LVMI (P < 0.05), baPWV (P < 0.001), NT-proBNP (P < 0.001), and Hs-cTnT (P < 0.001) were improved by adding morning home SBP to the SBP measurement.


CONCLUSIONS
Morning BP and evening BP provide equally useful information for subclinical target organ damage, yet multivariate modeling highlighted the stand-alone predictive ability of morning BP.
Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan; Department of Sleep and Circadian Cardiology, Jichi Medical University School of Medicine, Tochigi, Japan;
Satoshi
S
Hoshide
Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan; Department of Sleep and Circadian Cardiology, Jichi Medical University School of Medicine, Tochigi, Japan;
Kazuomi
K
Kario
Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan;
Yuichiro
Y
Yano
Haimoto Clinic, Aichi, Japan;
Hajime
H
Haimoto
Yamagiwa Clinic, Aichi, Japan;
Kayo
K
Yamagiwa
Oooka Clinic, Nagano, Japan;
Kiyoshi
K
Uchiba
Division of Endocrinology and Metabolism, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan;
Shoichiro
S
Nagasaka
Iwakuni City Medical Center Ishikai Hospital, Yamaguchi, Japan; and.
Yoshio
Y
Matsui
Chukyo Clinical, Aichi, Japan.
Akira
A
Nakamura
Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan;
Motoki
M
Fukutomi
Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan;
Kazuo
K
Eguchi
Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan;
Joji
J
Ishikawa
D000368:Aged; D000419:Albuminuria / Q000150:complications; D055109:Ankle Brachial Index; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D002318:Cardiovascular Diseases / Q000209:etiology*; D059168:Carotid Intima-Media Thickness; D002940:Circadian Rhythm; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D012307:Risk Factors
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
blood pressure; evening blood pressure; home blood pressure; hypertension; morning blood pressure; organ damage