Predictive power of home blood pressure and clinic blood pressure in hypertensive patients with impaired glucose metabolism and diabetes
OBJECTIVES:We evaluated the predictive power of home blood pressure and clinic blood pressure based on the long-term cardiovascular outcome in hypertensive patients with and without impaired glucose metabolism (IGM). METHOD:The multicentre Hypertension Objective Treatment Based on Measurement by Ele...
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| Veröffentlicht in: | Journal of hypertension 2013-08, Vol.31 (8), p.1593-1602 |
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| creator | Noguchi, Yuichi Asayama, Kei Staessen, Jan A Inaba, Munemichi Ohkubo, Takayoshi Hosaka, Miki Satoh, Michihiro Kamide, Kei Awata, Takuya Katayama, Shigehiro Imai, Yutaka |
| description | OBJECTIVES:We evaluated the predictive power of home blood pressure and clinic blood pressure based on the long-term cardiovascular outcome in hypertensive patients with and without impaired glucose metabolism (IGM).
METHOD:The multicentre Hypertension Objective Treatment Based on Measurement by Electrical Devices Blood Pressure trial (HOMED-BP) involved 3080 patients (50.5% women; mean age 59.7 years) with a baseline, untreated home/clinic blood pressure as well as follow-up, on-treatment blood pressure. Of those, 979 had IGM and 475 of these patients had diabetes. We applied Cox regression pooling all participants in a cohort analysis in which IGM and normal glucose metabolism (NGM) were separated.
RESULTS:During median 5.45 years follow-up, cardiovascular events occurred in 48 patients with IGM and 53 patients with NGM. Baseline home SBP significantly predicted cardiovascular outcome among IGM group [hazard ratio 1.68, 95% CI 1.26–2.26, P = 0.0005]. On-treatment home blood pressure was a significant predictor for cardiovascular risk even after the further adjustment of baseline blood pressure level (P ≤ 0.027), whereas on-treatment clinic blood pressure was not in NGM group (P ≥ 0.37). The event rate in IGM was approximately two times higher than that in NGM (9.95 vs. 4.88 per 1000 patient-years), resulted to the low 5-year number needed to treat in IGM patients [83 vs. 121 for 1–SD (13.1 mmHg) home SBP reduction, and 62 vs. 104 for 1–SD (9.5 mmHg) home DBP reduction).
CONCLUSION:The present findings suggest that long-term cardiovascular risk in IGM patients should be assessed based on home blood pressure, not on clinic blood pressure. |
| doi_str_mv | 10.1097/HJH.0b013e328361732c |
| format | Article |
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METHOD:The multicentre Hypertension Objective Treatment Based on Measurement by Electrical Devices Blood Pressure trial (HOMED-BP) involved 3080 patients (50.5% women; mean age 59.7 years) with a baseline, untreated home/clinic blood pressure as well as follow-up, on-treatment blood pressure. Of those, 979 had IGM and 475 of these patients had diabetes. We applied Cox regression pooling all participants in a cohort analysis in which IGM and normal glucose metabolism (NGM) were separated.
RESULTS:During median 5.45 years follow-up, cardiovascular events occurred in 48 patients with IGM and 53 patients with NGM. Baseline home SBP significantly predicted cardiovascular outcome among IGM group [hazard ratio 1.68, 95% CI 1.26–2.26, P = 0.0005]. On-treatment home blood pressure was a significant predictor for cardiovascular risk even after the further adjustment of baseline blood pressure level (P ≤ 0.027), whereas on-treatment clinic blood pressure was not in NGM group (P ≥ 0.37). The event rate in IGM was approximately two times higher than that in NGM (9.95 vs. 4.88 per 1000 patient-years), resulted to the low 5-year number needed to treat in IGM patients [83 vs. 121 for 1–SD (13.1 mmHg) home SBP reduction, and 62 vs. 104 for 1–SD (9.5 mmHg) home DBP reduction).
CONCLUSION:The present findings suggest that long-term cardiovascular risk in IGM patients should be assessed based on home blood pressure, not on clinic blood pressure.</description><identifier>ISSN: 0263-6352</identifier><identifier>EISSN: 1473-5598</identifier><identifier>DOI: 10.1097/HJH.0b013e328361732c</identifier><identifier>PMID: 23673350</identifier><language>eng</language><publisher>England: Wolters Kluwer Health | Lippincott Williams & Wilkins</publisher><subject>Adult ; Aged ; Antihypertensive Agents - therapeutic use ; Blood Pressure - drug effects ; Blood Pressure Determination - methods ; Blood Pressure Monitoring, Ambulatory - methods ; Cohort Studies ; Diabetes Mellitus - physiopathology ; Female ; Glucose - metabolism ; Humans ; Hypertension - diagnosis ; Hypertension - physiopathology ; Japan ; Male ; Middle Aged ; Predictive Value of Tests ; Proportional Hazards Models ; Self Care ; Treatment Outcome</subject><ispartof>Journal of hypertension, 2013-08, Vol.31 (8), p.1593-1602</ispartof><rights>2013 Wolters Kluwer Health | Lippincott Williams & Wilkins</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356c-aefe32b6556f50d59e0142873c20fe60af1784a9bfc725c2543c7c76fcbda5c73</citedby><cites>FETCH-LOGICAL-c356c-aefe32b6556f50d59e0142873c20fe60af1784a9bfc725c2543c7c76fcbda5c73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23673350$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Noguchi, Yuichi</creatorcontrib><creatorcontrib>Asayama, Kei</creatorcontrib><creatorcontrib>Staessen, Jan A</creatorcontrib><creatorcontrib>Inaba, Munemichi</creatorcontrib><creatorcontrib>Ohkubo, Takayoshi</creatorcontrib><creatorcontrib>Hosaka, Miki</creatorcontrib><creatorcontrib>Satoh, Michihiro</creatorcontrib><creatorcontrib>Kamide, Kei</creatorcontrib><creatorcontrib>Awata, Takuya</creatorcontrib><creatorcontrib>Katayama, Shigehiro</creatorcontrib><creatorcontrib>Imai, Yutaka</creatorcontrib><creatorcontrib>HOMED-BP study group</creatorcontrib><title>Predictive power of home blood pressure and clinic blood pressure in hypertensive patients with impaired glucose metabolism and diabetes</title><title>Journal of hypertension</title><addtitle>J Hypertens</addtitle><description>OBJECTIVES:We evaluated the predictive power of home blood pressure and clinic blood pressure based on the long-term cardiovascular outcome in hypertensive patients with and without impaired glucose metabolism (IGM).
METHOD:The multicentre Hypertension Objective Treatment Based on Measurement by Electrical Devices Blood Pressure trial (HOMED-BP) involved 3080 patients (50.5% women; mean age 59.7 years) with a baseline, untreated home/clinic blood pressure as well as follow-up, on-treatment blood pressure. Of those, 979 had IGM and 475 of these patients had diabetes. We applied Cox regression pooling all participants in a cohort analysis in which IGM and normal glucose metabolism (NGM) were separated.
RESULTS:During median 5.45 years follow-up, cardiovascular events occurred in 48 patients with IGM and 53 patients with NGM. Baseline home SBP significantly predicted cardiovascular outcome among IGM group [hazard ratio 1.68, 95% CI 1.26–2.26, P = 0.0005]. On-treatment home blood pressure was a significant predictor for cardiovascular risk even after the further adjustment of baseline blood pressure level (P ≤ 0.027), whereas on-treatment clinic blood pressure was not in NGM group (P ≥ 0.37). The event rate in IGM was approximately two times higher than that in NGM (9.95 vs. 4.88 per 1000 patient-years), resulted to the low 5-year number needed to treat in IGM patients [83 vs. 121 for 1–SD (13.1 mmHg) home SBP reduction, and 62 vs. 104 for 1–SD (9.5 mmHg) home DBP reduction).
CONCLUSION:The present findings suggest that long-term cardiovascular risk in IGM patients should be assessed based on home blood pressure, not on clinic blood pressure.</description><subject>Adult</subject><subject>Aged</subject><subject>Antihypertensive Agents - therapeutic use</subject><subject>Blood Pressure - drug effects</subject><subject>Blood Pressure Determination - methods</subject><subject>Blood Pressure Monitoring, Ambulatory - methods</subject><subject>Cohort Studies</subject><subject>Diabetes Mellitus - physiopathology</subject><subject>Female</subject><subject>Glucose - metabolism</subject><subject>Humans</subject><subject>Hypertension - diagnosis</subject><subject>Hypertension - physiopathology</subject><subject>Japan</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Predictive Value of Tests</subject><subject>Proportional Hazards Models</subject><subject>Self Care</subject><subject>Treatment Outcome</subject><issn>0263-6352</issn><issn>1473-5598</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1O3DAUhS1UxAw_b1BVXnYT6p_YTpYVKh0QEixgHTnONXHrxKntMOINeOxmGMqCRVd3cc_5ru45CH2m5JySWn3bXG_OSUsoB84qLqnizBygNS0VL4Soq09oTZjkheSCrdBxSr8IIVWt-BFaMS4V54Ks0ctdhM6Z7J4AT2ELEQeL-zAAbn0IHZ4ipDRHwHrssPFudObjxo24f54gZhjTK0ZnB2NOeOtyj90wabfcwI9-NiEBHiDrNniXhldm53QLGdIpOrTaJzh7myfo4fLH_cWmuLn9eXXx_aYwXEhTaLDLv60UQlpBOlEDoSWrFDeMWJBEW6qqUtetNYoJw0TJjTJKWtN2WhjFT9DXPXeK4c8MKTeDSwa81yOEOTU7mqCK1nyRlnupiSGlCLaZoht0fG4oaXYdNEsHzccOFtuXtwtzO0D3bvoX-iKo9oJt8Bli-u3nJfimB-1z_3_2X2JwmGQ</recordid><startdate>201308</startdate><enddate>201308</enddate><creator>Noguchi, Yuichi</creator><creator>Asayama, Kei</creator><creator>Staessen, Jan A</creator><creator>Inaba, Munemichi</creator><creator>Ohkubo, Takayoshi</creator><creator>Hosaka, Miki</creator><creator>Satoh, Michihiro</creator><creator>Kamide, Kei</creator><creator>Awata, Takuya</creator><creator>Katayama, Shigehiro</creator><creator>Imai, Yutaka</creator><general>Wolters Kluwer Health | Lippincott Williams & Wilkins</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201308</creationdate><title>Predictive power of home blood pressure and clinic blood pressure in hypertensive patients with impaired glucose metabolism and diabetes</title><author>Noguchi, Yuichi ; Asayama, Kei ; Staessen, Jan A ; Inaba, Munemichi ; Ohkubo, Takayoshi ; Hosaka, Miki ; Satoh, Michihiro ; Kamide, Kei ; Awata, Takuya ; Katayama, Shigehiro ; Imai, Yutaka</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356c-aefe32b6556f50d59e0142873c20fe60af1784a9bfc725c2543c7c76fcbda5c73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Antihypertensive Agents - therapeutic use</topic><topic>Blood Pressure - drug effects</topic><topic>Blood Pressure Determination - methods</topic><topic>Blood Pressure Monitoring, Ambulatory - methods</topic><topic>Cohort Studies</topic><topic>Diabetes Mellitus - physiopathology</topic><topic>Female</topic><topic>Glucose - metabolism</topic><topic>Humans</topic><topic>Hypertension - diagnosis</topic><topic>Hypertension - physiopathology</topic><topic>Japan</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Predictive Value of Tests</topic><topic>Proportional Hazards Models</topic><topic>Self Care</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Noguchi, Yuichi</creatorcontrib><creatorcontrib>Asayama, Kei</creatorcontrib><creatorcontrib>Staessen, Jan A</creatorcontrib><creatorcontrib>Inaba, Munemichi</creatorcontrib><creatorcontrib>Ohkubo, Takayoshi</creatorcontrib><creatorcontrib>Hosaka, Miki</creatorcontrib><creatorcontrib>Satoh, Michihiro</creatorcontrib><creatorcontrib>Kamide, Kei</creatorcontrib><creatorcontrib>Awata, Takuya</creatorcontrib><creatorcontrib>Katayama, Shigehiro</creatorcontrib><creatorcontrib>Imai, Yutaka</creatorcontrib><creatorcontrib>HOMED-BP study group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of hypertension</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Noguchi, Yuichi</au><au>Asayama, Kei</au><au>Staessen, Jan A</au><au>Inaba, Munemichi</au><au>Ohkubo, Takayoshi</au><au>Hosaka, Miki</au><au>Satoh, Michihiro</au><au>Kamide, Kei</au><au>Awata, Takuya</au><au>Katayama, Shigehiro</au><au>Imai, Yutaka</au><aucorp>HOMED-BP study group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictive power of home blood pressure and clinic blood pressure in hypertensive patients with impaired glucose metabolism and diabetes</atitle><jtitle>Journal of hypertension</jtitle><addtitle>J Hypertens</addtitle><date>2013-08</date><risdate>2013</risdate><volume>31</volume><issue>8</issue><spage>1593</spage><epage>1602</epage><pages>1593-1602</pages><issn>0263-6352</issn><eissn>1473-5598</eissn><abstract>OBJECTIVES:We evaluated the predictive power of home blood pressure and clinic blood pressure based on the long-term cardiovascular outcome in hypertensive patients with and without impaired glucose metabolism (IGM).
METHOD:The multicentre Hypertension Objective Treatment Based on Measurement by Electrical Devices Blood Pressure trial (HOMED-BP) involved 3080 patients (50.5% women; mean age 59.7 years) with a baseline, untreated home/clinic blood pressure as well as follow-up, on-treatment blood pressure. Of those, 979 had IGM and 475 of these patients had diabetes. We applied Cox regression pooling all participants in a cohort analysis in which IGM and normal glucose metabolism (NGM) were separated.
RESULTS:During median 5.45 years follow-up, cardiovascular events occurred in 48 patients with IGM and 53 patients with NGM. Baseline home SBP significantly predicted cardiovascular outcome among IGM group [hazard ratio 1.68, 95% CI 1.26–2.26, P = 0.0005]. On-treatment home blood pressure was a significant predictor for cardiovascular risk even after the further adjustment of baseline blood pressure level (P ≤ 0.027), whereas on-treatment clinic blood pressure was not in NGM group (P ≥ 0.37). The event rate in IGM was approximately two times higher than that in NGM (9.95 vs. 4.88 per 1000 patient-years), resulted to the low 5-year number needed to treat in IGM patients [83 vs. 121 for 1–SD (13.1 mmHg) home SBP reduction, and 62 vs. 104 for 1–SD (9.5 mmHg) home DBP reduction).
CONCLUSION:The present findings suggest that long-term cardiovascular risk in IGM patients should be assessed based on home blood pressure, not on clinic blood pressure.</abstract><cop>England</cop><pub>Wolters Kluwer Health | Lippincott Williams & Wilkins</pub><pmid>23673350</pmid><doi>10.1097/HJH.0b013e328361732c</doi><tpages>10</tpages></addata></record> |
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| ispartof | Journal of hypertension, 2013-08, Vol.31 (8), p.1593-1602 |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Adult Aged Antihypertensive Agents - therapeutic use Blood Pressure - drug effects Blood Pressure Determination - methods Blood Pressure Monitoring, Ambulatory - methods Cohort Studies Diabetes Mellitus - physiopathology Female Glucose - metabolism Humans Hypertension - diagnosis Hypertension - physiopathology Japan Male Middle Aged Predictive Value of Tests Proportional Hazards Models Self Care Treatment Outcome |
| title | Predictive power of home blood pressure and clinic blood pressure in hypertensive patients with impaired glucose metabolism and diabetes |
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