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Stroke risk in treated hypertension based on home blood pressure: the Ohasama study

Daisaku Yasui1, Kei Asayama, Takayoshi Ohkubo

  • 1Department of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Sciences and Medicine, Sendai, Japan.

American Journal of Hypertension
|February 27, 2010
PubMed

Insights

Home blood pressure (BP) monitoring offers a better assessment of stroke risk, particularly for treated hypertension patients, compared to casual BP measurements. This study highlights elevated home BP as a significant predictor of stroke.

Area of Science:

  • Cardiology
  • Neurology
  • Public Health

Background:

  • Observational studies suggest treated hypertensives have worse prognoses than nonhypertensives.
  • Limited evidence exists regarding home blood pressure (BP) measurement in this context.
  • This study compares stroke risk between treated and untreated individuals using home BP and casual BP.

Purpose of the Study:

  • To compare the risk of stroke between untreated individuals and those receiving antihypertensive medication.
  • To evaluate the utility of home BP versus casual BP in assessing stroke risk.
  • To investigate stroke risk stratification in treated hypertensives.

Main Methods:

  • Included 1,690 untreated and 700 treated subjects (aged >=35 years).
  • Measured home BP and casual BP at baseline.
  • Utilized Cox proportional hazards model to analyze first stroke risk over 11.9 years.

Main Results:

  • Observed 242 first-time stroke cases during follow-up.
  • Treated subjects showed higher stroke risk than untreated subjects based on both home BP (RH=1.48) and casual BP (RH=1.78).
  • Home BP demonstrated a linear increase in stroke risk for treated hypertensives (trend P < 0.01), unlike casual BP.

Conclusions:

  • Elevated home BP is strongly associated with an increased risk of stroke.
  • Home BP measurement is a superior tool for assessing stroke risk, especially in patients undergoing hypertension treatment.
  • Findings emphasize the importance of home BP monitoring for personalized risk assessment.
Abstract

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