Home blood pressure level and decline in renal function among treated hypertensive patients: the J-HOME-Morning Study.
We examined the association between home and office blood pressure (BP) levels and further decline in renal function among treated hypertensive patients with and without renal dysfunction. We calculated annual decline in estimated glomerular filtration rate (ΔeGFR) in 1535 treated hypertensive patients with home and office BP measurements. We defined ΔeGFR <0 as decline in renal function, and ΔeGFR ⩾0 as non-decline in renal function based on 1.5 years of follow-up. For 520 patients with low eGFR at baseline, morning home, evening home and office systolic BP (SBP) levels and morning home diastolic BP (DBP) levels were positively associated with the risk of decline in renal function (trend P=0.003, 0.002, 0.003 and 0.004). Compared to patients with home SBP <125 mm Hg, the risk of decline in renal function was higher in those with home SBPs ⩾135 mm Hg and between 130-135 mm Hg, while the risk was similar in those with home SBP of 125-130 mm Hg. For 1015 patients with normal eGFR at baseline, only morning home SBP level was positively associated with the risk of decline in renal function (trend P=0.004). Morning home BP might be useful for risk evaluation of decline in renal function even among treated hypertensive patients with normal renal function. Target levels of home BP control among treated hypertensive patients need to be further investigated.
Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan.
Kazuki
K
Ishikura
Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Japan.|Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan.|Tohoku University Tohoku Medical Megabank Organization, Sendai, Japan.
Taku
T
Obara
Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Japan.|Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan.
Masahiro
M
Kikuya
Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan.
Michihiro
M
Satoh
Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan.
Miki
M
Hosaka
Tohoku University Tohoku Medical Megabank Organization, Sendai, Japan.|Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Hirohito
H
Metoki
Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Hidekazu
H
Nishigori
Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan.
Nariyasu
N
Mano
Department of Nephrology and Hypertension, Fukushima Medical University, Fukushima, Japan.
Masaaki
M
Nakayama
Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan.
Yutaka
Y
Imai
Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.
Takayoshi
T
Ohkubo
D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D001795:Blood Pressure Determination; D018660:Blood Pressure Monitoring, Ambulatory; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology*; D007668:Kidney / Q000503:physiopathology*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged
D000959:Antihypertensive Agents