PS-C09-3: DETECTION OF NOCTURNAL HYPERTENSION BY SELF-MEASUREMENT OF BLOOD PRESSURE MEASUREMENT

Abstract

Outside-office BP measurements are recommended for the diagnosis of hypertension because of its better prediction for the cardiovascular (CV) risks compared to that of office BP. Nocturnal hypertension (NH), detectable only by outside-office measurement, is a strong CV risk predictor. However, in the real-world clinical setting, ambulatory blood pressure monitoring is not routinely conducted at least in part because of its annoyance (clinical inertia). In the present study, usefulness of home BP self-measurement, much easier to practice, upon detecting NH was sought. Subjects were patients with hypertension being treated in Ozono Clinc, Internal Medicine and Cardiology (n = 45, mean age72.8 +/-13, M26:F19). BP was self-measured by a sphygmomanometers provided by the clinic (OMRON HEM-7080 IC), which is equipped with timer-triggered BP measuring system at preset times. Patients were asked to record their morning BP (within one hour after getting-up) and evening BP (just before going to the bed). For detection of nocturnal BP, patients were informed to sleep with the cuffs set around their arms, then the recordings were obtained at 2:00. 3:00, 4:00 and 5:00. NH was defined as having the average of the four systolic BPs (SBPs) during sleep exceed 120 mmHg. Among the 45 patients 23 (51%) had NH. Relations between the existence of morning hypertension (SBP > 130 mmHg) or evening hypertension (SBP > 130 mmHg) and the existence of NH was shown in the table. When morning or evening hypertension exist, the prevalence of NH was around 60%. On the other hand, if morning hypertension does not exist, the rate of NH is very low. Interestingly, some patients without evening hypertension develop NH during night. Home blood pressure measurement is a convenient and useful clinical tool to estimate NH.