Different age‐related impacts of lean and obesity on cardiovascular prognosis in Japanese patients with cardiovascular risks: The J‐HOP (Japan Morning Surge‐Home Blood Pressure) Study

AbstractRenal denervation is a potential alternative to antihypertensive drug therapy. However, data on patient preference for this treatment option are limited and there are no data specifically from Asian patients. This study evaluated patient preference for renal denervation in patients with hypertension from Japan. Patients were a subset of those who participated in a March 2020 online electronic survey of patients with hypertension who had regularly visited medical institutions for treatment, were receiving antihypertensive drug therapy and had home blood pressure recordings available. The survey included a question about patient preference for treatment with renal denervation. A total of 2,392 patients were included (66% male, mean age 59.8 ± 11.6 years, mean duration of hypertension 11.4 ± 9.5 years). Preference for renal denervation was expressed by 755 patients (31.6%), and was higher in males than in females, in younger compared with older patients, in those with higher versus lower blood pressure, in patients who were less adherent versus more adherent to antihypertensive drug therapy, and in those who did rather than did not have antihypertensive drug-related side effects. Significant predictors of preference for renal denervation on logistic regression analysis were younger patient age, male sex, higher home or office systolic blood pressure, poor antihypertensive drug adherence, the presence of heart failure, and the presence of side effects during treatment with antihypertensive drugs. Overall, a relevant proportion of Japanese patients with hypertension expressed a preference for renal denervation. This should be taken into account when making shared decisions about antihypertensive drug therapy.

Download Full-text

Abstract 15551: Evening Blood Pressure Burden and Cardiac Load: A Sex-specific Association of Nocturia in the Japanese at High-risk of Cardiovascular Disease

Circulation ◽

10.1161/circ.142.suppl_3.15551 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Michiaki NAGAI ◽

Satoshi Hoshide ◽

Kazuomi Kario

Keyword(s):

Blood Pressure ◽

High Risk ◽

Significant Interaction ◽

Multinomial Logistic Regression ◽

Fasting Blood Glucose ◽

Epidemiologic Studies ◽

Home Blood Pressure ◽

Cardiovascular Risks ◽

Multinomial Logistic Regression Analysis ◽

Specific Association

Introduction: Earlier epidemiologic studies have reported a significant relationship between hypertension and nocturia. However, the underlying pathophysiology has been unclear. Hypothesis: We assessed the hypothesis that blood pressure (BP) burden and cardiac load might be associated with severity of nocturia. In addition, this association was hypothesized to be moderated by sex. Methods: In the Japan Morning Surge-Home Blood Pressure Study, measurements of home BP (HBP) at evening (mean 11.2 days) as well as brain natriuretic peptide (BNP) were performed in the 4310 patients with one or more cardiovascular risks (64.9 years old, male 47%). A self-administered questionnaire included items on nocturia was used. Results: According to the number of nocturia (no void: n= 2382; one void: n=847; ≥ 2 voids per night: n=1082), significant associations of systolic BP (SBP) at evening (130 vs 130 vs 132 mmHg, p<0.0001) and logBNP (1.20 vs 1.30 vs 1.42, p<0.0001) were observed with nocturia severity. In the multinomial logistic regression analysis adjustment for confounders including age, smoking, total cholesterol, fasting blood glucose, HbA1c and clinic SBP, the use of diuretics (OR: 1.26, 95%CI: 1.06-1.52, p<0.05) was significantly associated with one nocturnal void, while evening SBP (OR: 1.009, 95%CI: 1.003-1.014, p<0.01) and logBNP (1.43, 95%CI: 1.19-1.73, p<0.001) were significantly associated with multiple nocturnal voids. While no significant interaction was found between evening SBP and logBNP for multiple nocturnal voids in the total population (p=0.1), a significant interaction was found between evening SBP and logBNP for multiple nocturnal voids only in females (p<0.05). Conclusions: In conclusion, the use of diuretics was a significant indicator of single nocturnal void, while evening SBP and BNP were those of multiple nocturnal voids in the high-risk Japanese population. Specifically, in the females, treatment to reduce BP burden as well as cardiac overload might be important to improve sleep disturbance caused by nocturia.

Download Full-text

[OP.6A.01] CLINICAL SIGNIFICANCE OF STRICT HOME BLOOD PRESSURE CONTROL IN JAPANESE PATIENTS UNDERGOING ANTITHROMBOTIC TREATMENT

Journal of Hypertension ◽

10.1097/01.hjh.0000523119.01418.4f ◽

2017 ◽

Vol 35 ◽

pp. e55

Author(s):

S. Hoshide ◽

K. Eguchi ◽

K. Kario

Keyword(s):

Blood Pressure ◽

Clinical Significance ◽

Blood Pressure Control ◽

Japanese Patients ◽

Pressure Control ◽

Home Blood Pressure ◽

Antithrombotic Treatment

Download Full-text

Effect of canagliflozin on nocturnal home blood pressure in Japanese patients with type 2 diabetes mellitus: The SHIFT-J study

Journal of Clinical Hypertension ◽

10.1111/jch.13367 ◽

2018 ◽

Vol 20 (10) ◽

pp. 1527-1535 ◽

Cited By ~ 16

Author(s):

Kazuomi Kario ◽

Satoshi Hoshide ◽

Yukie Okawara ◽

Naoko Tomitani ◽

Kenji Yamauchi ◽

...

Keyword(s):

Diabetes Mellitus ◽

Blood Pressure ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Japanese Patients ◽

Home Blood Pressure

Download Full-text

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

American Journal of Hypertension ◽

10.1093/ajh/hpaa091 ◽

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 < 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 < 0.05). CONCLUSIONS The association between increased day-by-day home BP variability and impaired renal function was unique in diabetes.

Download Full-text

Early morning—Best time window of hourly 24‐hour ambulatory blood pressure in relation to hypertensive organ damage: The Japan Morning Surge‐Home Blood Pressure study

Journal of Clinical Hypertension ◽

10.1111/jch.13498 ◽

2019 ◽

Vol 21 (5) ◽

pp. 579-586 ◽

Cited By ~ 7

Author(s):

Sirisawat Wanthong ◽

Tomoyuki Kabutoya ◽

Satoshi Hoshide ◽

Peera Buranakitjaroen ◽

Kazuomi Kario

Keyword(s):

Blood Pressure ◽

Ambulatory Blood Pressure ◽

Time Window ◽

Organ Damage ◽

Early Morning ◽

Home Blood Pressure ◽

Blood Pressure Study

Download Full-text

Abstract 12026: Nocturnal Blood Pressure Burden, Diuretics, and Cardiac Load: Determinants of Nocturia in the Japanese at High-Risk of Cardiovascular Disease

Circulation ◽

10.1161/circ.132.suppl_3.12026 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Michiaki Nagai ◽

Satoshi Niijima ◽

Satoshi Hoshide ◽

Mami Takahashi ◽

Masahisa Shimpo ◽

...

Keyword(s):

Blood Pressure ◽

Cardiovascular Disease ◽

High Risk ◽

Significant Relationship ◽

Multinomial Logistic Regression ◽

Fasting Blood Glucose ◽

Antihypertensive Agents ◽

Home Blood Pressure ◽

Cardiovascular Risks ◽

Nocturnal Blood Pressure

Introduction: The majority of epidemiologic studies reported a significant relationship between hypertension and nocturia. However, the underlying pathophysiology has not been established. Hypothesis: We hypothesized that nocturnal blood pressure (BP) burden, some classes of antihypertensive agents and cardiac load might be associated with severity of noctria. In this study, the relationships of nocturia with self-measured home BP (HBP), the class of antihypertensive agent, B-type natriuretic peptide (BNP) were investigated in the Japanese at high-risk of cardiovascular disease. Methods: Among 4310 patients with one or more cardiovascular risks recruited for the Japan Morning Surge-Home Blood Pressure Study, the measurements of HBP at morning, evening, and nighttime as well as BNP were performed in the 2785 patients (63.5 years old, male 48.9%). A self-administered questionnaire included items on nocturia was used. Results: According to the number of nocturia (no void: n= 1571; one void: n=557; 2 or more voids per night: n=657), significant associations of systolic BP (SBP) at morning (136 vs 136 vs 140 mmHg, p<0.001), evening (129 vs 129 vs 131 mmHg, p<0.01) and nighttime (120 vs 120 vs 125 mmHg, p<0.001) as well as logBNP (1.15 vs 1.26 vs 1.39, p<0.001) were observed with nocturia severity. In the multinomial logistic regression analysis adjustment for confounders including age, smoking, total cholesterol, fasting blood glucose and HbA1c, the use of diuretics (OR: 1.28, 95%CI: 1.01-1.61, p<0.05) was significantly associated with one nocturnal void, while nighttime SBP (OR: 1.012, 95%CI: 1.01-1.02, p<0.001) and logBNP (1.46, 95%CI: 1.16-1.84, p<0.01) were significantly associated with multiple nocturnal voids. A significant interaction was found between nighttime SBP and logBNP for multiple nocturnal voids (p<0.01). On the other hand, neither morning SBP nor evening SBP had a significant relationship with nocturia. Conclusions: In this study, nighttime SBP and BNP were synergetically associated with severe nocturia in the high-risk Japanese population. Antihypertensive treatment to reduce BP burden during sleep as well as cardiac overload might be important to improve sleep quality caused by nocturia.

Download Full-text