Association of treatment-resistant hypertension defined by home blood pressure monitoring with cardiovascular outcome

In diagnosis of treatment-resistant hypertension (TRH), guidelines recommend out-of-office blood pressure (BP) measurements, ambulatory BP monitoring (ABPM) and home BP monitoring (HBPM). Although evidence of an association between ABPM-evaluated TRH and cardiovascular disease (CVD) prognosis has ac...

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Bibliographic Details
Published in:Hypertension research 2022-01, Vol.45 (1), p.75-86
Main Authors: Narita, Keisuke, Hoshide, Satoshi, Kario, Kazuomi
Format: Article
Language:English
Subjects:
Aged
Blood Pressure
Blood Pressure Monitoring, Ambulatory
Cardiovascular disease
Cardiovascular Diseases
Female
Heart failure
Humans
Hypertension
Hypertension - drug therapy
Male
Medical prognosis
Middle Aged
Prognosis
Stroke
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Summary:In diagnosis of treatment-resistant hypertension (TRH), guidelines recommend out-of-office blood pressure (BP) measurements, ambulatory BP monitoring (ABPM) and home BP monitoring (HBPM). Although evidence of an association between ABPM-evaluated TRH and cardiovascular disease (CVD) prognosis has accumulated, data are sparse regarding HBPM-evaluated TRH. We investigated this issue using data from the nationwide practice-based J-HOP (Japan Morning-Surge Home BP) study, which recruited 4,261 outpatients (mean age 64.9 years; 46.8% men; 91.5% hypertensives) who underwent morning and evening HBPM for 14 days. During 6.2 ± 3.8 years (26,418 person-years) follow-up, 270 total CVDs (stroke, coronary artery disease, aortic dissection, and heart failure) occurred. The adjusted hazard ratio (HR) (95% CIs) of uncontrolled TRH, i.e., uncontrolled BP using 3 classes of medications including diuretics or ≥4 classes of medications, for total CVD risk compared to controlled BP using
ISSN:0916-9636
1348-4214
DOI:10.1038/s41440-021-00757-4