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Differences between home blood pressure and strictly measured office blood pressure and their determinants in Japanese men

A Comment to this article was published on 02 February 2021


Conventional office blood pressure (OBP) and home blood pressure (HBP) measurements are often inconsistent. The purpose of this research was (1) to test whether strictly measured OBP values with sufficient rest time before measurement (st-OBP) is comparable to HBP at the population level and (2) to ascertain whether there are particular determinants for the difference between HBP and st-OBP at the individual level. Data from a population-based group of 1056 men aged 40–79 years were analyzed. After a five-min rest, st-OBP was measured twice. HBP was measured after a 2-min rest every morning for seven consecutive days. To determine factors related to ΔSBP (HBP minus st-OBP measurements), multiple linear regression analyses and analyses of covariance were performed. While st-OBP and HBP were comparable (136.5 vs. 137.2 mmHg) at the population level, ΔSBP varied with a standard deviation of 13.5 mmHg. Smoking was associated with a larger ΔSBP regardless of antihypertensive usage, and BMI was associated with a larger ΔSBP in participants using antihypertensive drugs. The adjusted mean ΔSBP in the highest BMI tertile category was 4.6 mmHg in participants taking antihypertensive drugs. st-OBP and HBP measurements were comparable at the population level, although the distribution of ΔSBP was considerably broad. Smokers and obese men taking antihypertensive drugs had higher HBP than st-OBP, indicating that their blood pressure levels are at risk of being underestimated. Therefore, this group would benefit from the addition of HBP measurements.

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The authors are deeply indebted to participants and staff members of the SESSA. The members of the SESSA are listed in the Appendix.


This study was supported by Grants-in-aid for Scientific Research (A) 13307016, (A) 17209023, (A) 21249043, (A) 23249036, (A) 25253046, (A) 15H02528, (B) 18H03048, and (C) 19K10642 from the Ministry of Education, Culture, Sports, Science, and Technology, Japan; by the National Institutes of Health in the USA [R01HL068200]; and by Glaxo-Smith Kline GB.

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Correspondence to Sayaka Kadowaki.

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SESSA Research Group members and their affiliation details are listed in Supplementary information

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Kadowaki, S., Kadowaki, T., Hozawa, A. et al. Differences between home blood pressure and strictly measured office blood pressure and their determinants in Japanese men. Hypertens Res 44, 80–87 (2021).

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