Difference between home and office blood pressures among treated hypertensive patients from the Japan Home versus Office Blood Pressure Measurement Evaluation (J-HOME) study.

摘要

This study sought to clarify the factors associated with the magnitude of the difference between home and office blood pressures in treated hypertensive patients. Study subjects consisted of 3,308 essential hypertensive patients (mean age, 66 years; males, 44%) receiving antihypertensive treatment in primary care settings in Japan. Patients were classified into 3 groups (the home effect group, small difference group, and office effect group) according to tertiles of the magnitude of the office-home systolic blood pressure difference. Compared to the other two groups, the home effect group patients were significantly and independently older, were more often habitual drinkers, had a greater family history of cerebrovascular disease or personal history of ischemic heart disease, and were prescribed a greater number of antihypertensive drugs, non-amlodipine calcium channel blockers, and alpha-blockers as antihypertensive drugs. Compared to the other two groups, the office effect group patients were significantly and independently younger, included more females, less frequently had a family history of cerebrovascular disease or personal history of ischemic heart disease, and were less often prescribed alpha-blockers as antihypertensive drugs. The characteristics of home effect group patients and the factors negatively affecting the blood pressure difference were the same. Among treated hypertensive patients, compared to patients in the other groups, office effect group patients had a lower-risk profile, whereas home effect group patients had a higher-risk profile. These predictive factors might be useful clinically to help identify patients who may have a large difference between home and office blood pressures.