title: Home versus office blood pressure: longitudinal relations with left ventricular hypertrophy: the Finn-Home study.
abstract: Electrocardiographically assessed left-ventricular hypertrophy (ECG-LVH) is a particularly high-risk phenomenon that is a part of every hypertensive patient's initial work-up. Several cross-sectional studies have demonstrated that home blood pressure (BP) has a stronger relation to LVH than office BP. However, longitudinal evidence on the association between home BP and target organ damage is scarce to nonexistent.
  
  
  
  We studied in a sample of 615 community-dwelling participants (mean age at baseline 53.7 ± 7.2, 58% women) whether change in home BP is more strongly associated with change in ECG-LVH than change in office BP over an 11-year follow-up.
  
  
  
  Pearson's correlation coefficients between changes in home/office SBP and changes in Sokolow-Lyon index, Cornell voltage, Cornell product and R wave amplitude in aVL were 0.21/0.18, 0.28/0.17, 0.25/0.16, and 0.32/0.20, respectively (asterisk indicates P < 0.05 for between-method difference in correlations with Steiger's z test). For change in home/office DBP and change in the aforementioned ECG-LVH indexes, the correlations were 0.12/0.12, 0.20/0.15, 0.16/0.12, and 0.28/0.19. Multivariable-adjusted regression modelling provided similar results. No clinically significant increase in correlations between home BP and ECG-LVH indexes occurred after the fourth day of home BP measurement.
  
  
  
  Our study demonstrates for the first time the superiority of home BP over office BP in the follow-up of left ventricular mass. The results of this and previous studies underline the importance of using out-of-office BP measurements as the primary method for assessing blood pressure levels.
authors.affiliation: aDepartment of Health, National Institute for Health and WelfarebUniversity of Turku, Turku, FinlandcFramingham Heart Study, Framingham, Massachusetts, USAdHeart CentreeDivision of Medicine, Turku University Hospital, Turku, Finland.
authors.forename: Sam S E
authors.initials: SS
authors.lastname: Sivén
authors.forename: Teemu J
authors.initials: TJ
authors.lastname: Niiranen
authors.forename: Ville L J
authors.initials: VL
authors.lastname: Langén
authors.forename: Pauli J
authors.initials: PJ
authors.lastname: Puukka
authors.forename: Ilkka M
authors.initials: IM
authors.lastname: Kantola
authors.forename: Antti M
authors.initials: AM
authors.lastname: Jula
mesh_terms: D000368:Aged; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D004562:Electrocardiography; D005260:Female; D005387:Finland; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000503:physiopathology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009819:Office Visits; D013599:Systole