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Review
. 2021 Mar;23(3):457-466.
doi: 10.1111/jch.14218. Epub 2021 Feb 16.

Clinical significance of nocturnal home blood pressure monitoring and nocturnal hypertension in Asia

Takeshi Fujiwara  1 , Satoshi Hoshide  1 , Naoko Tomitani  1 , Hao-Min Cheng  2   3   4   5 , Arieska Ann Soenarta  6 , Yuda Turana  7 , Chen-Huan Chen  2   3   4 , Huynh Van Minh  8 , Guru Prasad Sogunuru  9   10 , Jam Chin Tay  11 , Tzung-Dau Wang  12   13 , Yook-Chin Chia  14   15 , Narsingh Verma  16 , Yan Li  17 , Ji-Guang Wang  17 , Kazuomi Kario  1
Affiliations
Review

Clinical significance of nocturnal home blood pressure monitoring and nocturnal hypertension in Asia

Takeshi Fujiwara et al. J Clin Hypertens (Greenwich). 2021 Mar.

Abstract

Nocturnal home blood pressure (BP) monitoring has been used in clinical practice for ~20 years. The authors recently showed that nocturnal systolic BP (SBP) measured by a home BP monitoring (HBPM) device in a Japanese general practice population was a significant predictor of incident cardiovascular disease (CVD) events, independent of office and morning home SBP levels, and that masked nocturnal hypertension obtained by HBPM (defined as nocturnal home BP ≥ 120/70 mmHg and average morning and evening BP < 135/85 mmHg) was associated with an increased risk of CVD events compared with controlled BP (nocturnal home BP < 120/70 mmHg and average morning and evening BP < 135/85 mmHg). This evidence revealed that (a) it is feasible to use a nocturnal HBPM device for monitoring nocturnal BP levels, and (b) such a device may offer an alternative to ambulatory BP monitoring, which has been the gold standard for the measurement of nocturnal BP. However, many unresolved clinical problems remain, such as the measurement schedule and conditions for the use of nocturnal HBPM. Further investigation of the measurement of nocturnal BP using an HBPM device and assessments of the prognostic value are thus warranted. Asians are at high risk of developing nocturnal hypertension due to high salt sensitivity and salt intake, and the precise management of their nocturnal BP levels is important. Information and communication technology-based monitoring devices are expected to facilitate the management of nocturnal hypertension in Asian populations.

Keywords: Asia; blood pressure; blood pressure monitoring; nocturnal home blood pressure; nocturnal hypertension.

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Conflict of interest statement

Hao‐min Cheng has received speakers’ honoraria and sponsorship to attend conferences and CME seminars from Eli Lilly and AstraZeneca; Pfizer Inc; Bayer AG; Boehringer Ingelheim Pharmaceuticals, Inc; Daiichi Sankyo; Novartis Pharmaceuticals, Inc; Servier Co.; Pharmaceuticals Corporation; Sanofi; Takeda Pharmaceuticals International; and Menarini Co., Ltd. and has served as an advisor or consultant for ApoDx Technology, Inc Chen‐Huan Chen reports personal fees from Novartis, Sanofi, Daiichi Sankyo, Servier, Bayer, and Boehringer Ingelheim Pharmaceuticals, Inc Yook‐Chin Chia has received speaker honoraria and sponsorship to attend conferences and seminars from Boehringer Ingelheim, Pfizer, Omron, Servier, and Xepa‐Sol and investigator‐initiated research grants from Pfizer and Omron. Ji‐Guang Wang reports research grants from Chendu Di‐Ao and Omron, and lecture and consulting fees from AstraZeneca, Novartis, Omron, Servier, and Takeda. Kario reports research grants from Omron Healthcare, Fukuda Denshi, A&D, and Pfizer, Japan, and honoraria from Omron Healthcare. All other authors report no potential conflicts of interest in relation to this article.

Figures

FIGURE 1
FIGURE 1
The management of nocturnal hypertension in Asia
See this image and copyright information in PMC

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