Incorporating self-blood pressure measurements at home in the guideline from the Ohasama study
Incorporating self-blood pressure measurements at home in the guideline from the Ohasama study
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DOI：
10.1097/mbp.0b013e328244e8a7
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发表时间：
2007-12-01
影响因子：
1.3
通讯作者：
Imai, Yutaka
中科院分区：
文献类型：
--
作者：
Ohkubo, Takayoshi;Kikuya, Masahiro;Imai, Yutaka
最近的高血压治疗指南都强调了在家庭（家庭BID）自我血压（BP）测量在实践，研究和流行病学的临床应用中的重要性。在Ohasama研究中，一项基于家庭BP的队列研究，我们已经证明了将纳入这些指南的几个重要发现。我们证明，家庭BP更准确，更可靠地反映靶器官损害和心血管疾病的预后比传统的BP，而家庭BP的预测价值逐步增加的测量次数。即使是最初的第一次家庭BP值（一次测量）也显示出比传统BP值（两次测量的平均值）与中风风险的显著更大的关系。家庭血压在早上（早晨BID）和晚上（晚上BP）提供同样有用的信息中风的风险，而早晨高血压，这是专门观察到只有在早上，可能是一个很好的预测中风，特别是在个人使用抗高血压药物。与传统的Blip相比，家庭BID增加了指南分类的预测能力。使用设计用于家庭血压测量的设备在家中评估的心率值（家庭心率）与心血管死亡风险显著相关，与家庭血压无关。我们预计，对Ohasama数据的持续随访和进一步分析将有助于产生进一步的重要发现，值得纳入未来的高血压指南。
Recent guidelines for the treatment of hypertension have all emphasized the importance of self-blood pressure (BP) measurements at home (home BID) in clinical applications of practice, research, and epidemiology. In the Ohasama study, a cohort study based on home BP, we have demonstrated several important findings to be incorporated in those guidelines. We demonstrated that home BP more accurately and reliably reflect target organ damage and the prognosis of cardiovascular disease than conventional BP, whereas the predictive value of home BP increased progressively with the number of measurements. Even the initial-first home BP values (one measurement) showed a significantly greater relation with stroke risk than conventional BP values (mean of two measurements). Home BP in the morning (morning BID) and in the evening (evening BP) provide equally useful information for stroke risk, whereas morning hypertension, which is that specifically observed only in the morning, might be a good predicator of stroke, particularly among individuals using anti-hypertensive medication. Home BID increased the predictive power of categorizations of guidelines compared with conventional Blip. Heart rate values assessed at home using a device designed for home BP measurement (home heart rate) was significantly associated with the risk of cardiovascular mortality, independent of home BP We expect that continuous follow-up and further analysis of the Ohasama data would contribute to producing further important findings worth incorporating in future hypertension guidelines.