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  • Special Issue: Current evidence and perspectives for hypertension management in Asia
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Left ventricular mass as a predictor of cardiovascular events in the era of hypertension management using home blood pressure measurement: the J-HOP study

Hypertension Research volume 45, pages 1240–1248 (2022)Cite this article

Abstract

Target organ damage (TOD) is associated with a risk of cardiovascular disease (CVD) independent of blood pressure (BP); however, this association has been observed based on the assessment of office BP. We studied 1641 patients (mean age 64.8 ± 11.7 years) with CVD risk factors who underwent home BP measurement over a 14-day period and evaluated TOD at baseline and then performed follow-up examination of the J-HOP (Japan Morning Surge-Home Blood Pressure) study results. During the median follow-up of 6.6 ± 3.5 years, 115 participants experienced a CVD event. After adjustment for CVD risk factors, including office systolic BP, the adjusted hazard ratios expressing the risk of CVD events were 1.30 (95% confidence interval, 1.15–1.52), 1.27 (1.04–1.56), and 1.25 (1.11–1.40) per one-SD increase in log-transformed urinary albumin creatinine ratio (UACR, 0.57 mg/gCre), brachial-ankle pulse wave velocity (baPWV, 342 cm/s) and left ventricular mass index (LVMI, 26.6 g/m2) assessed by echocardiography, respectively. Even after adding home systolic BP as a covariate, these associations remained except for the association with baPWV (all P < 0.05). The C-statistic for the base model including office and home systolic BP for the risk of CVD events was 0.783 (95% CI: 0.743, 0.824), which significantly increased to 0.795 (95% CI: 0.757, 0.834) after adding LVMI, and changed slightly but not significantly with the addition of UACR or baPWV. Adding UACR, baPWV, or both to the model including LVMI did not improve CVD event prediction. In the modern era of hypertension management using home BP measurement, TOD indicators, especially LVMI, provide superior CVD event prediction independent of and beyond home BP.

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Acknowledgements

We gratefully acknowledge all participants who took part in the J-HOP study, as well as the investigators involved in the study. We also thank Ms. Ayako Okura for editorial assistance.

Funding

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 (to KK); a grant from the Foundation for Development of the Community (Tochigi, Japan); 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 to 2013; and funds from the MEXT-Supported Program for the Strategic Research Foundation at Private Universities, 2011 to 2015 Cooperative Basic and Clinical Research on Circadian Medicine (S1101022). The funding sponsors had no role in designing or conducting this study; in the collection, management, analysis, or interpretation of the data; in the preparation of the article; or in the decision to submit the article for publication.

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  1. Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan

    Hirotaka Waki, Satoshi Hoshide & Kazuomi Kario

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  1. Hirotaka Waki
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Correspondence to Kazuomi Kario.

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KK has received research grants from Omron Healthcare and A&D Co. The other authors have no competing interests to declare.

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Waki, H., Hoshide, S. & Kario, K. Left ventricular mass as a predictor of cardiovascular events in the era of hypertension management using home blood pressure measurement: the J-HOP study. Hypertens Res 45, 1240–1248 (2022). https://doi.org/10.1038/s41440-022-00927-y

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