Abstract

Objective: Although seasonal variation of nighttime home blood pressure (BP) was reported as higher in summer than winter, seasonal differences in the association of nighttime home BP with target organ damage (TOD) remains unclear. Hence, we assessed the seasonal variation of nighttime home BP and its association with TOD using a dataset of the Japan Morning Home-Surge BP (J-HOP) Nocturnal BP study. Design and method: This is a cross-sectional, post-hoc analysis using the dataset of the J-HOP Nocturnal BP study, which recruited patients with a history of or risk factors of cardiovascular disease. Participants underwent consecutive 14-day home BP measurements (morning and evening) and nighttime home BP measurements (a.m. 2, 3, and 4). Urine albumin creatinine ratio (UACR) and serum-brain natriuretic peptide (BNP) were collected at enrollment. Results: Among 2545 participants (age, 63.3 ± 10.3 yrs; antihypertensive medication use 82.6%), 629, 596, 719, and 601 participants were enrolled in spring, summer, autumn, and winter, respectively. Nighttime home systolic/diastolic BP (SBP/DBP) were higher in summer than in winter (SBP/DBP in summer, 123.3 ± 14.6/70.4 ± 8.9 mmHg; vs. in winter, 119.3 ± 14.0/69.1 ± 8.4 mmHg, each p value < 0.05 after adjusted with Bonferroni collection in each season), and the prevalence of riser pattern was also higher in summer than in winter (in summer, 27.2%; vs. in winter, 10.1%, p < 0.05). When the interaction between BP parameters and each season for the association with TOD was assessed, an association between riser pattern and UACR and an association between nighttime home DBP and BNP were stronger in winter compared to those in other seasons (both p for interaction < 0.05). Conclusions: In the present study, we revealed the association of nighttime home BP and TOD was stronger in winter than in other seasons.

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