scholarly journals Impact of indoor temperature instability on diurnal and day-by-day variability of home blood pressure in winter: a nationwide Smart Wellness Housing survey in Japan

2021 ◽  
Author(s):  
Wataru Umishio ◽  
Toshiharu Ikaga ◽  
Kazuomi Kario ◽  
Yoshihisa Fujino ◽  
Masaru Suzuki ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Linear Regression ◽  
Home Blood Pressure ◽  
Living Environment ◽  
Outdoor Temperature ◽  
Indoor Temperature ◽  
Diurnal Variability ◽  
Temperature Instability ◽  
The Mean ◽  
Day By Day

AbstractHome blood pressure (HBP) variability is an important factor for cardiovascular events. While several studies have examined the effects of individual attributes and lifestyle factors on reducing HBP variability, the effects of living environment remain unknown. We hypothesized that a stable home thermal environment contributes to reducing HBP variability. We conducted an epidemiological survey on HBP and indoor temperature in 3785 participants (2162 households) planning to have their houses retrofitted with insulation. HBP was measured twice in the morning and evening for 2 weeks in winter. Indoor temperature was recorded with each HBP observation. We calculated the morning-evening (ME) difference as an index of diurnal variability and the standard deviation (SD), coefficient of variation (CV), average real variability (ARV) and variability independent of the mean (VIM) as indices of day-by-day variability. The association between BP variability and temperature instability was analyzed using multiple linear regression models. The mean ME difference in indoor/outdoor temperature (a decrease in temperature overnight) was 3.2/1.5 °C, and the mean SD of indoor/outdoor temperature was 1.6/2.5 °C. Linear regression analyses showed that the ME difference in indoor temperature was closely correlated with the ME difference in systolic BP (0.85 mmHg/°C, p < 0.001). The SD of indoor temperature was also associated with the SD of systolic BP (0.61 mmHg/°C, p < 0.001). The CV, ARV, and VIM showed similar trends as the SD of BP. In contrast, outdoor temperature instability was not associated with either diurnal or day-by-day HBP variability. Therefore, residents should keep the indoor temperature stable to reduce BP variability.

Evaluation of day-by-day variability of home blood pressure using a home blood pressure telemonitoring system

2016 ◽  
Vol 21 (3) ◽  
pp. 184-188 ◽  
Author(s):  
Toshiki Kaihara ◽  
Kazuo Eguchi ◽  
Satoshi Hoshide ◽  
Kazuomi Kario
Keyword(s):  
Blood Pressure ◽  
Home Blood Pressure ◽  
Day By Day

scholarly journals Associations Between Day-by-Day Home Blood Pressure Variability and Renal Function and Albuminuria in Patients With and Without Diabetes

2020 ◽  
Vol 33 (9) ◽  
pp. 860-868
Author(s):  
Daisuke Suzuki ◽  
Satoshi Hoshide ◽  
Kazuomi Kario
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Home Blood Pressure ◽  
Diabetes Group ◽  
Urine Albumin ◽  
Blood Pressure Study ◽  
Average Real Variability ◽  
Day By Day

Abstract BACKGROUND The phenotype of diabetic kidney disease represents a lower estimated glomerular filtration rate (eGFR) and albuminuria. We investigated the association between day-by-day home blood pressure (BP) variability and the eGFR in subjects with diabetes and compared this association with that in subjects without diabetes. We then attempted to determine whether the association is present in albuminuria. METHODS We analyzed 4,231 patients with risk factors of cardiovascular disease (24.4% with diabetes) from the J-HOP (Japan Morning Surge-Home Blood Pressure) study. Home BP was measured in the morning and evening for 14 days. We calculated the SD, coefficient of variation, average real variability (ARV), and variation independent of the mean of the subjects’ morning and evening home systolic BP (SBP) as the indexes of day-by-day home BP variability. RESULTS A multiple linear regression analysis adjusted for covariates showed both average morning and evening SBP were associated with the log-transformed urine albumin-to-creatinine ratio (UACR) with and without diabetes (all P &lt; 0.05), but not with the eGFR except for an association of average evening SBP in the no-diabetes group. None of the indexes of day-by-day morning and evening home SBP variability were associated with the log-transformed UACR except for the association between the ARV of home morning SBP in the diabetes group. All of the indexes of day-by-day morning and evening home SBP variability were associated with the eGFR only in the diabetes group (all P &lt; 0.05). CONCLUSIONS The association between increased day-by-day home BP variability and impaired renal function was unique in diabetes.

scholarly journals Clinical Impact of the Maximum Mean Value of Home Blood Pressure on Cardiovascular Outcomes: A Novel Indicator of Home Blood Pressure Variability

Hypertension ◽  
2021 ◽  
Author(s):  
Takeshi Fujiwara ◽  
Satoshi Hoshide ◽  
Hiroshi Kanegae ◽  
Kazuomi Kario
Keyword(s):  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cox Regression ◽  
Mean Value ◽  
Home Blood Pressure ◽  
Antihypertensive Medications ◽  
Unique Identifier ◽  
Cox Regression Analysis ◽  
The Mean

We assessed the relationship between maximum mean home blood pressure (HBP) and incident cardiovascular disease risks in the general practice population of the J-HOP study (Japan Morning Surge-Home Blood Pressure), which recruited 4231 patients with cardiovascular risk factors (mean [SD] age: 65 [11] years; 53% women; 79% on antihypertensive medications) who measured their HBP in the morning and evening for 14 days. The first day’s HBPs were excluded. The average of morning and evening (the average of morning and evening value [MEave]) BP was defined as the average of all HBP values. The maximum mean HBP was defined as the highest value of mean HBP on one occasion. The variability independent of the mean of MEave BP was assessed. The MEave BP was 134/76 mm Hg; the maximum mean HBP was 156/88 mm Hg. Over a median 3.9-year follow-up (16 762 person-years), 72 stroke, and 76 coronary heart disease events occurred. A Cox regression analysis showed that the hazard ratios of a 1-SD increase in maximum mean home systolic BP (SBP; 95% CI) for incident stroke events were (1) 1.89 (1.23–2.89) including MEave SBP and (2) 1.68 (1.33–2.14) including the variability independent of the mean of MEave SBP. These significant associations were not observed for coronary heart disease events. Adding the maximum mean home SBP to the stroke prediction model significantly improved the discrimination: (1) MEave SBP: C statistics difference (95% CI), 0.019 (0.002–0.038); and (2) variability independent of the mean of MEave SBP: 0.031 (0.008–0.056). The maximum mean HBP could be a useful marker for evaluating the stroke risk of patients. REGISTRATION: URL: https://upload.umin.ac.jp ; Unique identifier: UMIN000000894

Stronger association of indoor temperature than outdoor temperature with blood pressure in colder months

2014 ◽  
Vol 32 (8) ◽  
pp. 1582-1589 ◽  
Author(s):  
Keigo Saeki ◽  
Kenji Obayashi ◽  
Junko Iwamoto ◽  
Nobuhiro Tone ◽  
Nozomi Okamoto ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Outdoor Temperature ◽  
Indoor Temperature

scholarly journals Cross-Sectional Analysis of the Relationship Between Home Blood Pressure and Indoor Temperature in Winter

Hypertension ◽  
2019 ◽  
Vol 74 (4) ◽  
pp. 756-766 ◽  
Author(s):  
Wataru Umishio ◽  
Toshiharu Ikaga ◽  
Kazuomi Kario ◽  
Yoshihisa Fujino ◽  
Tanji Hoshi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Home Blood Pressure ◽  
Indoor Temperature ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Sectional Analysis ◽  
The Relationship

Prognostic significance of day-by-day variability of home blood pressure on progression to macroalbuminuria in patients with diabetes

2018 ◽  
Vol 36 (5) ◽  
pp. 1068-1075 ◽  
Author(s):  
Emi Ushigome ◽  
Shinobu Matsumoto ◽  
Chikako Oyabu ◽  
Noriyuki Kitagawa ◽  
Toru Tanaka ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Prognostic Significance ◽  
Home Blood Pressure ◽  
Patients With Diabetes ◽  
Day By Day

scholarly journals Home Blood Pressure Control and Drug Prescription Patterns among Thai Hypertensives: A 1-Year Analysis of Telehealth Assisted Instrument in Home Blood Pressure Monitoring Nationwide Pilot Project

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Anut Sakulsupsiri ◽  
Pairoj Chattranukulchai ◽  
Sarawut Siwamogsatham ◽  
Patchaya Boonchayaanant ◽  
Witthawat Naeowong ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Channel Blocker ◽  
Blood Pressure Monitoring ◽  
Drug Prescription ◽  
Pilot Project ◽  
Home Blood Pressure ◽  
Pressure Monitoring ◽  
The Mean ◽  
One Year

Background. Several interventions have been proposed to improve hypertension control with various outcomes. The home blood pressure (HBP) measurement is widely accepted for assessing the response to medications. However, the enhancement of blood pressure (BP) control with HBP telemonitoring technology has yet to be studied in Thailand. Objective. To evaluate the attainment of HBP control and drug prescription patterns in Thai hypertensives at one year after initiating the TeleHealth Assisted Instrument in Home Blood Pressure Monitoring (THAI HBPM) nationwide pilot project. Methods. A multicenter, prospective study enrolled treated hypertensive adults without prior regular HBPM to obtain monthly self-measured HBP using the same validated, oscillometric telemonitoring devices. The HBP reading was transferred to the clinic via a cloud-based system, so the physicians can adjust the medications at each follow-up visit on a real-life basis. Controlled HBP is defined as having HBP data at one year of follow-up within the defined target range (<135/85 mmHg). Results. A total of 1,177 patients (mean age 58 ± 12.3 years, 59.4% women, 13.1% with diabetes) from 46 hospitals (81.5% primary care centers) were enrolled in the study. The mean clinic BP was 143.9 ± 18.1/84.3 ± 11.9 mmHg while the mean HBP was 134.4 ± 15.3/80.1 ± 9.4 mmHg with 609 (51.8%) patients having HBP reading <135/85 mmHg at enrollment. At one year of follow-up after implementing the HBP telemonitoring, 671 patients (57.0%) achieved HBP control. Patients with uncontrolled HBP had a higher prevalence of dyslipidemia and greater waist circumference than the controlled group. The majority of uncontrolled patients were still prescribed only one (36.0%) or two drugs (34.4%) at the end of the study. The antihypertensive drugs were not uptitrated in 136 (24%) patients with uncontrolled HBP at baseline. Calcium channel blocker was the most prescribed drug class (63.0%) followed by angiotensin-converting enzyme inhibitor (44.8%) while the thiazide-type diuretic was used in 18.9% of patients with controlled HBP and 16.4% in uncontrolled patients. Conclusion. With the implementation of HBP telemonitoring, the BP control rate based on HBP analysis was still low. This is possibly attributed to the therapeutic inertia of healthcare physicians. Calcium channel blocker was the most frequently used agent while the diuretic was underutilized. The long-term clinical benefit of overcoming therapeutic inertia alongside HBP telemonitoring needs to be validated in a future study.

scholarly journals Feasibility of a New Cuffless Device for Ambulatory Blood Pressure Measurement in Patients With Hypertension: Mixed Methods Study (Preprint)

2018 ◽  
Author(s):  
Paula AM Ogink ◽  
Jelske M de Jong ◽  
Mats Koeneman ◽  
Mariska Weenk ◽  
Lucien JLPG Engelen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Qualitative Interviews ◽  
Blood Pressure Measurement ◽  
Home Blood Pressure ◽  
Strongly Correlated ◽  
User Friendliness ◽  
Validated Questionnaire ◽  
System Usability Scale ◽  
The Mean

BACKGROUND Frequent home blood pressure (BP) measurements result in a better estimation of the true BP. However, traditional cuff-based BP measurements are troublesome for patients. OBJECTIVE This study aimed to evaluate the feasibility of a cuffless device for ambulatory systolic blood pressure (SBP) measurement. METHODS This was a mixed method feasibility study in patients with hypertension. Performance of ambulatory SBPs with the device was analyzed quantitatively by intrauser reproducibility and comparability to a classic home BP monitor. Correct use by the patients was checked with video, and user-friendliness was assessed using a validated questionnaire, the System Usability Scale (SUS). Patient experiences were assessed using qualitative interviews. RESULTS A total of 1020 SBP measurements were performed using the Checkme monitor in 11 patients with hypertension. Duplicate SBPs showed a high intrauser correlation (R=0.86, P<.001). SBPs measured by the Checkme monitor did not correlate well with those of the different home monitors (R=0.47, P=.007). However, the mean SBPs measured by the Checkme and home monitors over the 3-week follow-up were strongly correlated (R=0.75, P=.008). In addition, 36.4% (n=4) of the participants performed the Checkme measurements without any mistakes. The mean SUS score was 86.4 (SD 8.3). The most important facilitator was the ease of using the Checkme monitor. Most important barriers included the absence of diastolic BP and the incidental difficulties in obtaining an SBP result. CONCLUSIONS Given the good intrauser reproducibility, user-friendliness, and patient experience, all of which facilitate patients to perform frequent measurements, cuffless BP monitoring may change the way patients measure their BP at home in the context of ambulant hypertension management.

Abstract P184: Is Home Blood Pressure More Strongly Associated with Coronary Artery Calcification Than Clinic Blood Pressure Measured Under an Appropriate Condition?

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Atsushi Satoh ◽  
Hisatomi Arima ◽  
Atsushi Hozawa ◽  
Takashi Hisamatsu ◽  
Sayaka Kadowaki ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Coronary Artery ◽  
Coronary Artery Calcification ◽  
Home Blood Pressure ◽  
Agatston Score ◽  
Ideal Condition ◽  
Clinic Blood Pressure ◽  
Cross Sectional ◽  
Electrical Device ◽  
The Mean

Background / Objective: A number of studies have shown that home blood pressure (HBP) is more strongly associated with atherosclerotic diseases than clinic blood pressure (CBP). In previous studies, however, measurement of CBP under suboptimal conditions might have undermined the usefulness of CBP for prediction of atherosclerotic diseases. Therefore, we conducted a cross-sectional analysis to clarify whether HBP is more strongly associated with coronary artery calcification (CAC) than strictly measured CBP among a general population of Japanese men. Methods: From 2006 to 2008, we recruited 1094 male participants randomly selected from the residents in Kusatsu City, Shiga, Japan. CBP was measured twice consecutively by a trained physician using electrical device after 5 minutes of complete rest in a sitting position in a silent room. The participants were asked to measure HBP with an electrical device once in the morning during the consecutive 7 days. HBP was measured in seated position after 2 minutes of rest, within an hour after waking up, after urination and before breakfast. The mean of 2 measurements of CBP and the mean of 7 days of HBP were used in the analysis. CAC was assessed using computed tomography. Presence of CAC was defined as Agatston score >10. After exclusion of 175 participants with missing data on HBP, CBP, or CAC, a total of 919 people were included into the present analysis. We calculated multivariable-adjusted odds ratios (ORs) for presence of CAC per one standard deviation (SD) increase of CBP and HBP, then compared by adding interaction terms to the statistical model. ORs were adjusted for age, body mass index, history of cardiovascular diseases, smoking, ethanol consumption, blood sugar, serum total cholesterol, high density lipoprotein cholesterol, and use of medication (hypertension, dyslipidemia, and diabetes mellitus). Results: The mean systolic CBP (SD) and HBP (SD) were 136.8 (19.0) mmHg and 137.2 (18.5) mmHg, respectively. CBP and HBP were highly correlated (r = 0.74 P <0.001). The difference between CBP and HBP was not significant (P = 0.595). CAC was found in 454 (49.4%) participants. Multivariable-adjusted ORs (95% confidence interval) for presence of CAC were comparable between CBP (1.34 (1.14 - 1.58) per 1SD increase) and HBP (1.37 (1.16 - 1.62) per 1SD increase) (P heterogeneity = 0.819). When mean value of the first 2 days of HBP was used as a sensitivity analysis, we found almost the same results (P heterogeneity = 0.992). Similar results were also obtained for diastolic CBP and HBP (P heterogeneity = 0.968 for 7 days of HBP, 0.566 for 2 days of HBP). Conclusion: In conclusion, the association of CBP measured in an ideal condition with CAC was comparable with that of HBP.

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