【論文摘要】The Japan Morning Surge Home Blood Pressure (J-HOP) Study: Design, Achievement, and Perspectives

Kazuomi Kario

《海峽循環醫學雜誌》 1卷2S期 (2019/09) Pp. 30-31

https://doi.org/10.6907/SCJ.201909/SP_1(2).0025

摘要

Up until now, there are only 5 clinic-based prospective studies including Asian 3 studies such as JHOP study, HONEST study, and HOMED BP study. The characteristics of the JHOP study is the nationwide real-world prospective study using the same home blood pressure monitoring (HBPM) device and the same home BP measurement schedule according to the guidelines. For this study, we developed the new HBPM device which could automatically measure nocturnal BP at home (Medinote, Omron, Kyoto). The study subjects are the outpatients with cardiovascular risk factors, and cardiovascular outcomes has been followed. At the baseline, in addition to HBPM, ambulatory BP monitoring, echocardiography, carotid echography, brachial-ankle pulse wave velocity measurements, and the blood biomarkers (BNP, CRP, high-sensitive TnT, etc.) were assessed as the option tests. This study achieved to identify the following 3 major prospective evidences. 1) morning home BP is the more sensitive predictor of stroke than evening home BP. 2) Day-by-day home BP variability is associated with cardiovascular outcomes independently of the average of home BPs. 3) nocturnal home BP is associated with both stroke and coronary artery disease prognosis independently of morning and evening home BPs. Based on these findings, we stress the importance of practical home BP-guided staged approach for the 24-hr BP management of hypertension targeting firstly morning home BP to all hypertensive patients, and secondly nighttime home BP especially to the high-risk patients. Near in future, the individualized approach using information and communication technology (ICT) anticipation medicine based on the individual home BP variability would be the ideal antihypertensive strategy to achieve cardiovascular event ＂zero＂.