Sleep blood pressure measured using a home blood pressure monitor was independently associated with cardiovascular disease incidence: the Nagahama study.


Journal

Journal of hypertension
ISSN: 1473-5598
Titre abrégé: J Hypertens
Pays: Netherlands
ID NLM: 8306882

Informations de publication

Date de publication:
28 May 2024
Historique:
medline: 6 6 2024
pubmed: 6 6 2024
entrez: 6 6 2024
Statut: aheadofprint

Résumé

Nocturnal blood pressure (BP) is associated with cardiovascular disease independently of awake BP. However, nocturnal BP measured using an ambulatory monitoring device has limited reproducibility because it is a single-day measurement. We investigated the association between sleep BP measured on multiple days using a timer-equipped home BP monitor and cardiovascular diseases in a general population. The study population comprised 5814 community residents. Participants were required to sleep with wrapping cuffs on their upper arm and BP was measured automatically at 0 : 00, 2 : 00, and 4 : 00. Actigraph was used to determine BP measured during sleep. Participants were also measured home morning and evening BP manually using the same device. During the 7.3-year mean follow-up period, we observed 117 cases of cardiovascular diseases. The association between sleep BP (per 10 mmHg hazard ratio = 1.31, P < 0.001) and cardiovascular events remained significant (hazard ratio = 1.22, P = 0.036) even after adjusting for office BP and confounding factors, such as sleep-disordered breathing. Individuals with sleep-only hypertension (n = 1047; hazard ratio = 2.23, P = 0.005) had a significant cardiovascular risk. Daytime-only hypertension (n = 264; hazard ratio = 3.57, P = 0.001) and combined sleep and daytime hypertension (n = 1216; hazard ratio = 3.69, P < 0.001) was associated with cardiovascular events to the same extent. Sleep BP dipping was not identified as a significant determinant of cardiovascular events. Sleep BP measured using a home BP monitor was independently associated with the incidence of cardiovascular disease in a general population.

Sections du résumé

BACKGROUND BACKGROUND
Nocturnal blood pressure (BP) is associated with cardiovascular disease independently of awake BP. However, nocturnal BP measured using an ambulatory monitoring device has limited reproducibility because it is a single-day measurement. We investigated the association between sleep BP measured on multiple days using a timer-equipped home BP monitor and cardiovascular diseases in a general population.
METHODS METHODS
The study population comprised 5814 community residents. Participants were required to sleep with wrapping cuffs on their upper arm and BP was measured automatically at 0 : 00, 2 : 00, and 4 : 00. Actigraph was used to determine BP measured during sleep. Participants were also measured home morning and evening BP manually using the same device.
RESULTS RESULTS
During the 7.3-year mean follow-up period, we observed 117 cases of cardiovascular diseases. The association between sleep BP (per 10 mmHg hazard ratio = 1.31, P < 0.001) and cardiovascular events remained significant (hazard ratio = 1.22, P = 0.036) even after adjusting for office BP and confounding factors, such as sleep-disordered breathing. Individuals with sleep-only hypertension (n = 1047; hazard ratio = 2.23, P = 0.005) had a significant cardiovascular risk. Daytime-only hypertension (n = 264; hazard ratio = 3.57, P = 0.001) and combined sleep and daytime hypertension (n = 1216; hazard ratio = 3.69, P < 0.001) was associated with cardiovascular events to the same extent. Sleep BP dipping was not identified as a significant determinant of cardiovascular events.
CONCLUSION CONCLUSIONS
Sleep BP measured using a home BP monitor was independently associated with the incidence of cardiovascular disease in a general population.

Identifiants

pubmed: 38842010
doi: 10.1097/HJH.0000000000003781
pii: 00004872-990000000-00482
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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Auteurs

Yasuharu Tabara (Y)

Graduate School of Public Health, Shizuoka Graduate University of Public Health, Aoi-ku, Shizuoka.
Center for Genomic Medicine.

Takeshi Matsumoto (T)

Department of Respiratory Medicine.

Kimihiko Murase (K)

Department of Respiratory Medicine.

Kazuya Setoh (K)

Graduate School of Public Health, Shizuoka Graduate University of Public Health, Aoi-ku, Shizuoka.

Takahisa Kawaguchi (T)

Center for Genomic Medicine.

Tomoko Wakamura (T)

Department of Human Health Science, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto.

Toyohiro Hirai (T)

Department of Respiratory Medicine.

Kazuo Chin (K)

Center for Genomic Medicine.
Department of Sleep Medicine and Respiratory Care, Division of Sleep Medicine, Nihon University of Medicine, Itabashi-ku, Tokyo, Japan.

Fumihiko Matsuda (F)

Center for Genomic Medicine.

Classifications MeSH