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Home versus office blood pressure: longitudinal relations with left ventricular hypertrophy: the Finn-Home study

Sam S E Sivén1, Teemu J Niiranen, Ville L J Langén

  • 1aDepartment of Health, National Institute for Health and WelfarebUniversity of Turku, Turku, FinlandcFramingham Heart Study, Framingham, Massachusetts, USAdHeart CentreeDivision of Medicine, Turku University Hospital, Turku, Finland.

Journal of Hypertension
|December 23, 2016
PubMed

Insights

Home blood pressure (BP) monitoring is superior to office BP for tracking left ventricular hypertrophy (LVH) over time. This finding highlights the importance of out-of-office BP measurements in managing hypertensive patients.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Diagnostic Imaging

Background:

  • Electrocardiographically assessed left-ventricular hypertrophy (ECG-LVH) is a significant risk factor in hypertensive patients.
  • Home blood pressure (BP) monitoring shows a stronger association with LVH than office BP in cross-sectional studies.
  • Longitudinal data on home BP and target organ damage, like LVH, are limited.

Purpose of the Study:

  • To investigate whether changes in home BP are more strongly associated with changes in ECG-LVH than changes in office BP.
  • To provide longitudinal evidence on the relationship between home BP monitoring and left ventricular mass over 11 years.

Main Methods:

  • A longitudinal study of 615 community-dwelling participants over 11 years.
  • Assessed changes in home BP and office BP (systolic and diastolic).
  • Evaluated changes in ECG-LVH using Sokolow-Lyon index, Cornell voltage, Cornell product, and R wave amplitude in aVL.

Main Results:

  • Changes in home BP demonstrated stronger correlations with changes in ECG-LVH indexes compared to office BP.
  • Correlation coefficients for home BP vs. ECG-LVH were consistently higher than for office BP vs. ECG-LVH.
  • No significant increase in correlations was observed after the fourth day of home BP measurement.

Conclusions:

  • Home blood pressure monitoring is superior to office blood pressure for assessing left ventricular mass changes over time.
  • These findings underscore the importance of out-of-office BP measurements as a primary tool for blood pressure assessment.
  • The study provides novel longitudinal evidence supporting the clinical utility of home BP monitoring in hypertension management.
Abstract

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