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Home systolic blood pressure time in therapeutic range and cardiovascular risk: the practitioner-based nationwide J-HOP study extended

Hypertension Research volume 47, pages 112–119 (2024)Cite this article

Abstract

Time in therapeutic range (TTR) for office systolic blood pressure (SBP) is an independent predictor of major cardiovascular events. However, the clinical implications of TTR for home SBP have not yet been investigated. This study determined the association between TTR of home SBP and cardiovascular events in individuals with ≥1 cardiovascular risk factor who were enrolled in The Japan Morning Surge-Home Blood Pressure (J-HOP) study. The therapeutic range for home SBP was defined as home SBP of 100–135 mmHg during the 13-day baseline period of the J-HOP study. Participants were divided into subgroups based on quartiles of TTR for home SBP, and the risk of cardiovascular events was determined in each quartile. During a mean 6.3 years of follow-up in 4070 participants (mean age 65 years), cardiovascular events included stroke in 92, coronary artery disease in 119, heart failure in 41 and aortic dissection in 8. The adjusted hazard ratio (95% confidence interval) for the risk of total cardiovascular events in participants with home SBP TTR in the lowest (100%) versus highest quartile (<15.3%) was 1.74 (1.16–2.61); the corresponding hazard ratio for stroke events was 2.11 (1.06–4.21). A 10% decrease in home SBP TTR was associated with a 4% increase in the risk of total cardiovascular events (p = 0.033) and a 9% increase in the risk of stroke (p = 0.004). The significant association seen between home SBP TTR and the occurrence of cardio- and cerebrovascular events highlights the importance of achieving stable reductions in home SBP and minimizing day-by-day home BP variability.

Clinical Trial Registration: University Hospital Medical Information Network Clinical Trials Registry, UMIN000000894 (J-HOP study).

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Acknowledgements

Medical writing support was provided by Nicola Ryan, independent medical writer, and by Ayako Okura, English publication coordinator, funded by Jichi Medical University.

Funding

The J-HOP study was financially supported in part by a grant from the Foundation for the Development of the Community (Tochigi).

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Authors and Affiliations

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

    Kazuomi Kario, Naoko Tomitani, Yukie Okawara & Satoshi Hoshide

  2. Genki Plaza Medical Center for Health Care, Tokyo, Japan

    Hiroshi Kanegae

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  1. Kazuomi Kario
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  2. Naoko Tomitani
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  3. Yukie Okawara
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  4. Hiroshi Kanegae
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  5. Satoshi Hoshide
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Contributions

Study conception and design: KK, SH, and NT. Data preparation: KK and SH. Data analysis: HK and YO. Data interpretation: KK, NT, SH, and all. Drafting and revising of the manuscript: KK, NT, and SH. Final approval of the submitted manuscript: KK, NT, SH, YO, and HK.

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Correspondence to Kazuomi Kario.

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KK has received research funding from Omron Healthcare Co, Fukuda Denshi, and A&D Co. None of the other authors have any conflicts of interest to disclose.

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Kario, K., Tomitani, N., Okawara, Y. et al. Home systolic blood pressure time in therapeutic range and cardiovascular risk: the practitioner-based nationwide J-HOP study extended. Hypertens Res 47, 112–119 (2024). https://doi.org/10.1038/s41440-023-01416-6

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