Maximum home systolic blood pressure is a marker of carotid atherosclerosis

ABSTRACT

Background: Maximum home systolic blood pressure (maximum SBP) has been reported as a parameter of blood pressure (BP) variability. We tested the hypothesis that maximum SBP is one of the risk factors of hypertensive target organ damage (TOD).

Methods: We conducted a cross-sectional study of 4,310 subjects with>1 cardiovascular risk factor. The subjects measured their home BP for 14 consecutive days. Mean and maximum SBPs were used as independent variables. As dependent variables, we used left ventricular mass index (LVMI), brachial-ankle pulse wave velocity (baPWV), maximum carotid intima-media thickness (CIMT), and urine albumin creatinine ratio (UACR).

Results: In a multiple regression analysis, the subjects' mean and maximum SBPs were significantly associated with the above TOD markers. Compared to mean SBP, maximum SBP demonstrated a significantly stronger association with CIMT (p<0.001).

Conclusion: Based on its clinical significance herein, measurement of maximum home SBP is warranted in addition to measurement of mean home SBP.

KEYWORDS:

• Blood pressure variability
• maximum systolic blood pressure
• carotid atherosclerosis
• carotid intima-media thickness

Acknowledgments

We thank the numerous study investigators, fellows, nurses, and research coordinators at each of the J-HOP study sites. We also thank Ms. Kimiyo Saito for the study coordination and data management, and Ms. Ayako Okura for editorial assistance.

Conflicts of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Additional information

Funding

This study was financially supported in part by a grant from the 21st Century Center of Excellence Project overseen by Japan’s Ministry of Education, Culture, Sports, Science and Technology; a grant from the Foundation for Development of the Community (Tochigi); a grant from Omron Healthcare Co., Ltd, a Grant-in-Aid for Scientific Research (B) (21390247) from The Ministry of Education, Culture, Sports, Science and Technology (MEXT) of Japan, 2009–2013; and funds from the MEXT-supported Program for the Strategic Research Foundation at Private Universities, 2011–2015 Cooperative Basic and Clinical Research on Circadian Medicine (S1101022) to K. Kario. Funding sponsors had no involvement in the study design or the conducting of the study; collection, management, analysis, or the decision to submit the article for publication.