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Characteristics of resistant hypertension determined by self-measured blood pressure at home and office blood pressure measurements: the J-HOME study.
J Hypertens 2006; 24(9):1737-43JH

Abstract

OBJECTIVES

To diagnose resistant hypertension using self-measured blood pressure (BP) at home and office BP, and to evaluate the characteristics of resistant hypertensive patients.

METHODS

The subjects were 528 hypertensive patients taking at least three or more different antihypertensive drugs. Subjects were classified into four groups (controlled hypertension, isolated office resistant hypertension, isolated home resistant hypertension and sustained resistant hypertension) on the basis of the cut-off values of home BP (135/85 mmHg) and office BP (140/90 mmHg). The relationship between each resistant hypertension group and various factors was analysed using univariate and multivariate analyses.

RESULTS

Of the 528 patients, 17.8% were classified with controlled hypertension, 16.1% with isolated office resistant hypertension, 23.5% with isolated home resistant hypertension and 42.6% with sustained resistant hypertension. The presence of hypercholesterolemia was found to have a significant and independent association with isolated office resistant hypertension. Higher office systolic blood pressure (SBP), a past history of ischaemic heart disease, and a lower prescription rate of potassium-sparing diuretics were found to have a significant and independent association with isolated home resistant hypertension. Patients with sustained resistant hypertension had a significantly lower prescription rate of potassium-sparing diuretics than those with controlled hypertension.

CONCLUSIONS

The present study demonstrated that resistant hypertension is mediated at least partly by the white-coat effect. Home BP measurements and other relevant factors associated with resistant hypertension, such as relatively higher office SBP, type of drugs prescribed, and cardiovascular complications, should be taken into account for the diagnosis and treatment of resistant hypertension.

Authors+Show Affiliations

Department of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Science and Medicine, Sendai, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16915022

Citation

Oikawa, Takuya, et al. "Characteristics of Resistant Hypertension Determined By Self-measured Blood Pressure at Home and Office Blood Pressure Measurements: the J-HOME Study." Journal of Hypertension, vol. 24, no. 9, 2006, pp. 1737-43.
Oikawa T, Obara T, Ohkubo T, et al. Characteristics of resistant hypertension determined by self-measured blood pressure at home and office blood pressure measurements: the J-HOME study. J Hypertens. 2006;24(9):1737-43.
Oikawa, T., Obara, T., Ohkubo, T., Kikuya, M., Asayama, K., Metoki, H., ... Imai, Y. (2006). Characteristics of resistant hypertension determined by self-measured blood pressure at home and office blood pressure measurements: the J-HOME study. Journal of Hypertension, 24(9), pp. 1737-43.
Oikawa T, et al. Characteristics of Resistant Hypertension Determined By Self-measured Blood Pressure at Home and Office Blood Pressure Measurements: the J-HOME Study. J Hypertens. 2006;24(9):1737-43. PubMed PMID: 16915022.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characteristics of resistant hypertension determined by self-measured blood pressure at home and office blood pressure measurements: the J-HOME study. AU - Oikawa,Takuya, AU - Obara,Taku, AU - Ohkubo,Takayoshi, AU - Kikuya,Masahiro, AU - Asayama,Kei, AU - Metoki,Hirohito, AU - Komai,Rie, AU - Murai,Kayo, AU - Hashimoto,Junichiro, AU - Totsune,Kazuhito, AU - Imai,Yutaka, AU - ,, PY - 2006/8/18/pubmed PY - 2007/1/18/medline PY - 2006/8/18/entrez SP - 1737 EP - 43 JF - Journal of hypertension JO - J. Hypertens. VL - 24 IS - 9 N2 - OBJECTIVES: To diagnose resistant hypertension using self-measured blood pressure (BP) at home and office BP, and to evaluate the characteristics of resistant hypertensive patients. METHODS: The subjects were 528 hypertensive patients taking at least three or more different antihypertensive drugs. Subjects were classified into four groups (controlled hypertension, isolated office resistant hypertension, isolated home resistant hypertension and sustained resistant hypertension) on the basis of the cut-off values of home BP (135/85 mmHg) and office BP (140/90 mmHg). The relationship between each resistant hypertension group and various factors was analysed using univariate and multivariate analyses. RESULTS: Of the 528 patients, 17.8% were classified with controlled hypertension, 16.1% with isolated office resistant hypertension, 23.5% with isolated home resistant hypertension and 42.6% with sustained resistant hypertension. The presence of hypercholesterolemia was found to have a significant and independent association with isolated office resistant hypertension. Higher office systolic blood pressure (SBP), a past history of ischaemic heart disease, and a lower prescription rate of potassium-sparing diuretics were found to have a significant and independent association with isolated home resistant hypertension. Patients with sustained resistant hypertension had a significantly lower prescription rate of potassium-sparing diuretics than those with controlled hypertension. CONCLUSIONS: The present study demonstrated that resistant hypertension is mediated at least partly by the white-coat effect. Home BP measurements and other relevant factors associated with resistant hypertension, such as relatively higher office SBP, type of drugs prescribed, and cardiovascular complications, should be taken into account for the diagnosis and treatment of resistant hypertension. SN - 0263-6352 UR - https://www.unboundmedicine.com/medline/citation/16915022/Characteristics_of_resistant_hypertension_determined_by_self_measured_blood_pressure_at_home_and_office_blood_pressure_measurements:_the_J_HOME_study_ L2 - http://dx.doi.org/10.1097/01.hjh.0000242397.53214.27 DB - PRIME DP - Unbound Medicine ER -