Influence of home blood pressure measuring conditions in the evening on the morning–evening home blood pressure difference in treated hypertensive patients: the J-HOME study

Abstract

The objective of this study was to clarify the factors affecting the morning-evening home systolic blood pressure (BP) difference (home systolic ME dif) in treated hypertensive patients, including evening home BP measuring conditions, based on the data from the Japan Home versus Office BP Measurement Evaluation study. The study participants were 3303 essential hypertensive patients (mean age 66.2+/-10.5 years; females 55.3%) treated using antihypertensive drug therapy in primary care settings in Japan. Multivariate regression analysis including the variables that were significantly associated with the home systolic ME dif on the univariate analysis was performed. The mean of the home systolic/diastolic ME dif was 6.1+/-10.8/4.8+/-6.5 mmHg. The proportion of patients measuring evening BP after drinking alcohol was 20.5%, and the proportion of patients measuring evening BP after bathing was 76.8%. Uncontrolled morning systolic BP (morning systolic BP > or =135 mmHg), controlled evening systolic BP (evening systolic BP <135 mmHg), older age (> or =65 years), measurement of evening BP after drinking, and measurement of evening BP after bathing were positively associated with the home systolic ME dif on multivariate regression analysis. Measurement of evening BP after drinking and measurement of evening BP after bathing were strongly associated with an increased home systolic ME dif, independent of morning and evening home BP levels. Therefore, evening home BP measuring conditions (before or after drinking alcohol and bathing) should be taken into account while evaluating the home systolic ME dif.