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

Takeshi Fujiwara¹, Satoshi Hoshide¹, Naoko Tomitani¹, Hao-Min Cheng^{2

3

4

5}, Arieska Ann Soenarta⁶, Yuda Turana⁷, Chen-Huan Chen^{2

3

4}, Huynh Van Minh⁸, Guru Prasad Sogunuru^{9

10}, Jam Chin Tay¹¹, Tzung-Dau Wang^{12

13}, Yook-Chin Chia^{14

15}, Narsingh Verma¹⁶, Yan Li¹⁷, Ji-Guang Wang¹⁷, Kazuomi Kario¹

Affiliations

¹ Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan.
² Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
³ Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
⁴ Institute of Public Health and Community Medicine Research Center, National Yang-Ming University School of Medicine, Taipei, Taiwan.
⁵ Center for Evidence-Based Medicine, Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan.
⁶ Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia-National Cardiovascular Center, Jakarta, Indonesia.
⁷ Faculty of Medical and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia.
⁸ Department of Internal Medicine, University of Medicine and Pharmacy, Hue University, Hue, Vietnam.
⁹ Department of Cardiology, MIOT International Hospital, Chennai, India.
¹⁰ College of Medical Sciences, Kathmandu University, Bharatpur, Nepal.
¹¹ Department of General Medicine, Tan Tock Seng Hospital, Singapore, Singapore.
¹² Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan.
¹³ Division of Hospital Medicine, Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan.
¹⁴ Department of Medical Sciences, School of Healthcare and Medical Sciences, Sunway University, Bandar Sunway, Malaysia.
¹⁵ Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
¹⁶ Department of Physiology, King George's Medical University, Lucknow, India.
¹⁷ Department of Hypertension, Centre for Epidemiological Studies and Clinical Trials, The Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

PMID: 33591641
PMCID: PMC8029527
DOI: 10.1111/jch.14218

Review

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

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

. 2021 Mar;23(3):457-466.

doi: 10.1111/jch.14218. Epub 2021 Feb 16.

Authors

Affiliations

¹ Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan.
² Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
³ Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
⁴ Institute of Public Health and Community Medicine Research Center, National Yang-Ming University School of Medicine, Taipei, Taiwan.
⁵ Center for Evidence-Based Medicine, Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan.
⁶ Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia-National Cardiovascular Center, Jakarta, Indonesia.
⁷ Faculty of Medical and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia.
⁸ Department of Internal Medicine, University of Medicine and Pharmacy, Hue University, Hue, Vietnam.
⁹ Department of Cardiology, MIOT International Hospital, Chennai, India.
¹⁰ College of Medical Sciences, Kathmandu University, Bharatpur, Nepal.
¹¹ Department of General Medicine, Tan Tock Seng Hospital, Singapore, Singapore.
¹² Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan.
¹³ Division of Hospital Medicine, Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan.
¹⁴ Department of Medical Sciences, School of Healthcare and Medical Sciences, Sunway University, Bandar Sunway, Malaysia.
¹⁵ Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
¹⁶ Department of Physiology, King George's Medical University, Lucknow, India.
¹⁷ Department of Hypertension, Centre for Epidemiological Studies and Clinical Trials, The Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

PMID: 33591641
PMCID: PMC8029527
DOI: 10.1111/jch.14218

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**
The management of nocturnal hypertension in Asia

See this image and copyright information in PMC

References

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

Affiliations

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

Authors

Affiliations

Abstract

Conflict of interest statement

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References

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MeSH terms

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Full Text Sources

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Medical