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Evening home blood pressure and pulse rate: age-specific associations with nocturia severity


Previous studies have reported a significant relationship between hypertension and nocturia. However, the underlying pathophysiology associated with pulse rate (PR) remains unclear. In the Japan Morning Surge-Home Blood Pressure Study, a self-administered nocturia questionnaire and evening home blood pressure (BP) and PR measurements (taken on a mean of 11.2 days) were performed on 4310 patients with one or more cardiovascular risk factors (mean: 64.9 years old; 47% male). According to the number of nighttime voids, the study population was divided into three groups (no voids: n = 2382; 1 void: n = 847; ≥2 voids per night: n = 1082). In the multinomial logistic regression analysis adjusted for confounders, diuretic use (OR, 1.23; 95%CI, 1.01–1.50; p < 0.05) was significantly associated with one nocturnal void, whereas evening home systolic BP (SBP) (OR per 1 SD, 1.14; 95%CI, 1.05–1.24; p < 0.01) and evening home PR (OR per 1 SD, 1.12; 95%CI: 1.02–1.24; p < 0.05) were significantly associated with multiple nocturnal voids. In the younger group (<65 years), only evening home PR was significantly related to multiple nighttime voids (p < 0.01), whereas in the older group (≥65 years), only evening home SBP was significantly related to multiple nighttime voids (p = 0.02). In this study, both higher evening home PR and higher evening home SBP were associated with multiple nighttime voids, with the former playing a greater role in the younger participants, and the latter more often associating the older group. An age-stratified approach to reduce the burden of BP or PR might be important to improve sleep quality.

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Fig. 1: Number of nocturnal voids.

Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.


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We gratefully acknowledge the numerous study investigators, fellows, nurses, and research coordinators at each of the study sites that participated in the J-HOP study. The centers and physicians who participated in this study are presented in the online-only Data Supplement. We also gratefully acknowledge Ms Kimiyo Saito for the coordination and data management of this study, and Ms Ayako Okura for editorial assistance.


This study was financially supported, in part, by a grant from the 21st Century Center of Excellence Project run 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 KK. Funding sponsors had no role in the study design or in conducting the study; in the collection, management, analysis, and interpretation of the data; in the preparation of the paper, or in the decision to submit the paper for publication.

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Authors and Affiliations



Conceptualization: MN, SH, KK. Project administration: MN. Supervision: SH, KK. Writing—original draft: MN, SH, KK. Writing—review & editing: MN, SH, KK.

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Correspondence to Kazuomi Kario.

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Competing interests

KK reports research grant from A&D, Omron Healthcare, Fukuda Denshi, CureApp, Sanwa Kagaku Kenkyusho, Teijin Pharma, Boehringer Ingelheim Japan, Fukuda Lifetec; consulting fees from A&D, JIMRO, Omron Healthcare, CureApp, Terumo, Fukuda Denshi; honoraria from Otsuka Pharmaceuticals, Omron Healthcare; participation in Advisory Board of Fukuda Denshi; Patent, Fukuda Denshi, outside the submitted work. The other authors report no competing interests.

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Nagai, M., Hoshide, S. & Kario, K. Evening home blood pressure and pulse rate: age-specific associations with nocturia severity. J Hum Hypertens (2023).

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