Abstract
Despite the clinical usefulness of self-measured home blood pressure (BP), reports on the characteristics of home BP have not been sufficient and have varied due to the measurement conditions in each study. We constructed a database on self-measured home BP, which included five Japanese general populations as subdivided aggregate data that were clustered and meta-analyzed according to sex, age category, and antihypertensive drug treatment at baseline (treated and untreated). The self-measured home BPs were collected after a few minutes of rest in a sitting position: (1) the morning home BP was measured within 1 h of waking, after urination, before breakfast, and before taking antihypertensive medication (if any); and (2) the evening home BP was measured just before going to bed. The pulse rate was simultaneously measured. Eligible data from 2000 onward were obtained. The morning BP was significantly higher in treated participants than in untreated people of the same age category, and the BP difference was more marked in women. Among untreated residents, home systolic/diastolic BPs measured in the morning were higher than those measured in the evening; the differences were 5.7/5.0 mmHg in women (ranges across the cohorts, 5.3–6.8/4.7–5.4 mmHg) and 7.3/7.7 mmHg in men (ranges, 6.4–8.5/7.0–8.7 mmHg). In contrast, the home pulse rate in women and men was 2.4 (range, 1.5–3.7) and 5.6 (range, 4.6–6.6) beats per minute, respectively, higher in the evening than in the morning. We demonstrated the current status of home BP and home pulse rate in relation to sex, age, and antihypertensive treatment status in the Japanese general population. The approach by which fine-clustered aggregate statistics were collected and integrated could address practical issues raised in epidemiological research settings.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Umemura S, Arima H, Arima S, Asayama K, Dohi Y, Hirooka Y, et al. The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2019). Hypertens Res. 2019;42:1235–481.
Kokubo Y, Okamura T, Watanabe M, Higashiyama A, Ono Y, Miyamoto Y, et al. The combined impact of blood pressure category and glucose abnormality on the incidence of cardiovascular diseases in a Japanese urban cohort: the Suita Study. Hypertens Res. 2010;33:1238–43.
Ninomiya T, Kiyohara Y, Tokuda Y, Doi Y, Arima H, Harada A, et al. Impact of kidney disease and blood pressure on the development of cardiovascular disease: an overview from the Japan Arteriosclerosis Longitudinal Study. Circulation. 2008;118:2694–701.
Asayama K, Ohkubo T, Rakugi H, Miyakawa M, Mori H, Katsuya T, et al. Comparison of blood pressure values-self-measured at home, measured at an unattended office, and measured at a conventional attended office. Hypertens Res. 2019;42:1726–37.
Asayama K. Observational study and participant-level meta-analysis on antihypertensive drug treatment-related cardiovascular risk. Hypertens Res. 2017;40:856–60.
Asayama K, Li Y, Franklin SS, Thijs L, O’Brien E, Staessen JA. Cardiovascular risk associated with white-coat hypertension: con side of the argument. Hypertension. 2017;70:676–82.
Imai Y, Hosaka M, Elnagar N, Satoh M. Clinical significance of home blood pressure measurements for the prevention and management of high blood pressure. Clin Exp Pharm Physiol. 2014;41:37–45.
Asayama K, Fujiwara T, Hoshide S, Ohkubo T, Kario K, Stergiou GS, et al. Nocturnal blood pressure measured by home devices: evidence and perspective for clinical application. J Hypertens. 2019;37:905–16.
Ohkubo T, Imai Y, Tsuji I, Nagai K, Kato J, Kikuchi N, et al. Home blood pressure measurement has a stronger predictive power for mortality than does screening blood pressure measurement: a population-based observation in Ohasama, Japan. J Hypertens. 1998;16:971–5.
Asayama K, Ohkubo T, Kikuya M, Metoki H, Hoshi H, Hashimoto J, et al. Prediction of stroke by self-measurement of blood pressure at home versus casual screening blood pressure measurement in relation to the JNC-7 classification: the Ohasama study. Stroke. 2004;35:2356–61.
Yasui D, Asayama K, Ohkubo T, Kikuya M, Kanno A, Hara A, et al. Stroke risk in treated hypertension based on home blood pressure: the Ohasama study. Am J Hypertens. 2010;23:508–14.
Niiranen TJ, Thijs L, Asayama K, Johansson JK, Ohkubo T, Kikuya M, et al. The International Database of HOme blood pressure in relation to Cardiovascular Outcome (IDHOCO): moving from baseline characteristics to research perspectives. Hypertens Res. 2012;35:1072–9.
Stergiou GS, Nasothimiou EG, Kalogeropoulos PG, Pantazis N, Baibas NM. The optimal home blood pressure monitoring schedule based on the Didima outcome study. J Hum Hypertens. 2010;24:158–64.
Imai Y, Nishiyama A, Sekino M, Aihara A, Kikuya M, Ohkubo T, et al. Characteristics of blood pressure measured at home in the morning and in the evening: the Ohasama study. J Hypertens. 1999;17:889–98.
Hata J, Ninomiya T, Hirakawa Y, Nagata M, Mukai N, Gotoh S, et al. Secular trends in cardiovascular disease and its risk factors in Japanese: half-century data from the Hisayama Study (1961–2009). Circulation. 2013;128:1198–205.
Asayama K, Ohkubo T, Hoshide S, Kario K, Ohya Y, Rakugi H, et al. From mercury sphygmomanometer to electric device on blood pressure measurement: correspondence of Minamata Convention on Mercury. Hypertens Res. 2016;39:179–82.
Shirasaki O, Terada H, Niwano K, Nakanishi T, Kanai M, Miyawaki Y, et al. The Japan Home-Health Apparatus Industrial Association: investigation of home-use electronic sphygmomanometers. Blood Press Monit. 2001;6:303–7.
Hozawa A, Ohkubo T, Kikuya M, Ugajin T, Yamaguchi J, Asayama K, et al. Prognostic value of home heart rate for cardiovascular mortality in the general population: the Ohasama study. Am J Hypertens. 2004;17:1005–10.
Imai Y, Otsuka K, Kawano Y, Shimada K, Hayashi H, Tochikubo O, et al. Japanese society of hypertension (JSH) guidelines for self-monitoring of blood pressure at home. Hypertens Res. 2003;26:771–82.
Oishi E, Ohara T, Sakata S, Fukuhara M, Hata J, Yoshida D, et al. Day-to-day blood pressure variability and risk of dementia in a general japanese elderly population: The Hisayama Study. Circulation. 2017;136:516–25.
Sakata S, Hata J, Fukuhara M, Yonemoto K, Mukai N, Yoshida D, et al. Morning and evening blood pressures are associated with intima-media thickness in a general population—The Hisayama Study. Circ J. 2017;81:1647–53.
Tabara Y, Matsumoto T, Murase K, Setoh K, Kawaguchi T, Nagashima S, et al. Day-to-day home blood pressure variability and orthostatic hypotension: The Nagahama Study. Am J Hypertens. 2018;31:1278–85.
Matsumoto A, Satoh M, Kikuya M, Ohkubo T, Hirano M, Inoue R, et al. Day-to-day variability in home blood pressure is associated with cognitive decline: the Ohasama study. Hypertension. 2014;63:1333–8.
Satoh M, Hosaka M, Asayama K, Kikuya M, Inoue R, Metoki H, et al. Aldosterone-to-renin ratio and nocturnal blood pressure decline assessed by self-measurement of blood pressure at home: the Ohasama Study. Clin Exp Hypertens. 2014;36:108–14.
Hisamatsu T, Miura K, Ohkubo T, Arima H, Fujiyoshi A, Satoh A, et al. Home blood pressure variability and subclinical atherosclerosis in multiple vascular beds: a population-based study. J Hypertens. 2018;36:2193–203.
Ryuno H, Kamide K, Gondo Y, Kabayama M, Oguro R, Nakama C, et al. Longitudinal association of hypertension and diabetes mellitus with cognitive functioning in a general 70-year-old population: the SONIC study. Hypertens Res. 2017;40:665–70.
Godai K, Kabayama M, Gondo Y, Yasumoto S, Sekiguchi T, Noma T, et al. Day-to-day blood pressure variability is associated with lower cognitive performance among the Japanese community-dwelling oldest-old population: the SONIC study. Hypertens Res. 2020;43:404–11.
Coleman A, Freeman P, Steel S, Shennan A. Validation of the Omron 705IT (HEM-759-E) oscillometric blood pressure monitoring device according to the British Hypertension Society protocol. Blood Press Monit. 2006;11:27–32.
El Assaad MA, Topouchian JA, Asmar RG. Evaluation of two devices for self-measurement of blood pressure according to the international protocol: the Omron M5-I and the Omron 705IT. Blood Press Monit. 2003;8:127–33.
dabl® Educational Trust Limited. dabl Educational Trust. 2004. http://dableducational.org/. Accessed 2 Apr 2020.
International Organization for Standardization. ISO 81060-2:2013, non-invasive sphygmomanometers—part 2: clinical investigation of automated measurement type. 2013. https://www.iso.org/standard/57977.html. Accessed 2 Apr 2020.
Godai K, Kabayama M, Saito K, Asayama K, Yamamoto K, Sugimoto K, et al. Validation of an automated home blood pressure measurement device in oldest-old populations. Hypertens Res. 2020;43:30–5.
Chonan K, Kikuya M, Araki T, Fujiwara T, Suzuki M, Michimata M, et al. Device for the self-measurement of blood pressure that can monitor blood pressure during sleep. Blood Press Monit. 2001;6:203–5.
Bland JM, Altman DG. Multiple significance tests: the Bonferroni method. BMJ. 1995;310:170.
Niiranen TJ, Jula AM, Kantola IM, Reunanen A. Comparison of agreement between clinic and home-measured blood pressure in the Finnish population: the Finn-HOME Study. J Hypertens. 2006;24:1549–55.
Mejia AD, Julius S, Jones KA, Schork NJ, Kneisley J. The Tecumseh Blood Pressure Study. Normative data on blood pressure self-determination. Arch Intern Med. 1990;150:1209–13.
Odili AN, Abdullahi B, Nwankwo AM, Asayama K, Staessen JA. Characteristics of self-measured home blood pressure in a Nigerian urban community: the NIPREGH study. Blood Press Monit. 2015;20:260–5.
Aparicio LS, Barochiner J, Cuffaro PE, Alfie J, Rada MA, Morales MS, et al. Determinants of the morning-evening home blood pressure difference in treated hypertensives: The HIBA-Home Study. Int J Hypertens. 2014;2014:569259.
Johansson JK, Niiranen TJ, Puukka PJ, Jula AM. Factors affecting the difference between morning and evening home blood pressure: the Finn-Home study. Blood Press. 2011;20:27–36.
Asayama K, Ohkubo T, Kikuya M, Obara T, Metoki H, Inoue R, et al. Prediction of stroke by home “morning” versus “evening” blood pressure values: the Ohasama study. Hypertension. 2006;48:737–43.
Imai Y, Ohkubo T, Tsuji I, Hozawa A, Nagai K, Kikuya M, et al. Relationships among blood pressures obtained using different measurement methods in the general population of Ohasama, Japan. Hypertens Res. 1999;22:261–72.
Yatabe J, Yatabe MS, Morimoto S, Watanabe T, Ichihara A. Effects of room temperature on home blood pressure variations: findings from a long-term observational study in Aizumisato Town. Hypertens Res. 2017;40:785–7.
Saeki K, Obayashi K, Iwamoto J, Tone N, Okamoto N, Tomioka K, et al. Stronger association of indoor temperature than outdoor temperature with blood pressure in colder months. J Hypertens. 2014;32:1582–9.
Asayama K, Hozawa A, Taguri M, Ohkubo T, Tabara Y, Suzuki K, et al. Blood pressure, heart rate, and double product in a pooled cohort: the Japan Arteriosclerosis Longitudinal Study. J Hypertens. 2017;35:1808–15.
Wolf-Maier K, Cooper RS, Banegas JR, Giampaoli S, Hense HW, Joffres M, et al. Hypertension prevalence and blood pressure levels in 6 European countries, Canada, and the United States. JAMA. 2003;289:2363–9.
Satoh M, Metoki H, Asayama K, Murakami T, Inoue R, Tsubota-Utsugi M, et al. Age-related trends in home blood pressure, home pulse rate, and day-to-day blood pressure and pulse rate variability based on longitudinal cohort data: the Ohasama study. J Am Heart Assoc. 2019;8:e012121.
Obara T, Ohkubo T, Komai R, Asayama K, Kikuya M, Metoki H, et al. Control of home heart rate and home blood pressure levels in treated patients with hypertension: the J-HOME study. Blood Press Monit. 2007;12:289–95.
Ohkubo T, Obara T, Funahashi J, Kikuya M, Asayama K, Metoki H, et al. Control of blood pressure as measured at home and office, and comparison with physicians’ assessment of control among treated hypertensive patients in Japan: First Report of the Japan Home versus Office Blood Pressure Measurement Evaluation (J-HOME) study. Hypertens Res. 2004;27:755–63.
Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018;39:3021–104.
Whelton PK, Carey RM, Aronow WS, Casey DE Jr., Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018;71:e13–e115.
Niiranen TJ, Asayama K, Thijs L, Johansson JK, Ohkubo T, Kikuya M, et al. Outcome-driven thresholds for home blood pressure measurement: international database of home blood pressure in relation to cardiovascular outcome. Hypertension. 2013;61:27–34.
Statistics Bureau of Japan. Population and households of Japan 2015. 2015. https://www.stat.go.jp/english/data/kokusei/2015/poj/mokuji.html. Accessed 22 May 2020.
Modesti PA, Rapi S, Rogolino A, Tosi B, Galanti G. Seasonal blood pressure variation: implications for cardiovascular risk stratification. Hypertens Res. 2018;41:475–82.
Hanazawa T, Asayama K, Imai Y, Ohkubo T. Response to Yatabe et al. Hypertens Res. 2017;40:789–90.
Acknowledgements
We would like to express our deepest appreciation to all of the MDAS study collaborators for their valuable contribution. We thank the staff of Teikyo University for their valuable help.
Funding
This study was also supported by Grants-in-Aid for Scientific Research (17H04126) from the Ministry of Education, Culture, Sports, Science and Technology, Japan.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
Omron Healthcare provided research support to KA, KK, and TO. Daiichi Sankyo provided honoraria and research support to KK. The other authors declare that they have no conflict of interest.
Additional information
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Asayama, K., Tabara, Y., Oishi, E. et al. Recent status of self-measured home blood pressure in the Japanese general population: a modern database on self-measured home blood pressure (MDAS). Hypertens Res 43, 1403–1412 (2020). https://doi.org/10.1038/s41440-020-0530-1
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/s41440-020-0530-1
Keywords
This article is cited by
-
Predictive power of home blood pressure in the evening compared with home blood pressure in the morning and office blood pressure before treatment and in the on-treatment follow-up period: a post hoc analysis of the HOMED-BP study
Hypertension Research (2022)
-
In-office and out-of-office blood pressure measurement
Journal of Human Hypertension (2021)
-
Difference between morning and evening home blood pressure and cardiovascular events: the J-HOP Study (Japan Morning Surge-Home Blood Pressure)
Hypertension Research (2021)