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TOPLINE:
Higher nighttime blood pressure (BP) measured with a wrist‑type device that caused less sleep disturbance was independently associated with a larger left ventricular (LV) mass index and increased odds of left ventricular hypertrophy (LVH), and the risk threshold differed between men and women.
METHODOLOGY:
- Researchers conducted a substudy of the multicenter prospective WISDOM-Night study to examine whether wrist‑measured nighttime home BP was associated with the odds of LVH.
- They included 1218 patients with treated or untreated hypertension (office BP ≥ 130/80 mm Hg) or heart failure. Patients were from Japanese medical centers between 2021 and 2024. Their mean age was 67.2 years, and 656 of them were men.
- Patients used a wrist-cuff oscillometric home BP monitoring device (Omron Healthcare) for 7 days and recorded two seated readings each morning and before bedtime. The device automatically recorded BP at 2:00, 3:00, and 4:00 AM and at 4 hours after bedtime, and upper-arm BP was measured twice per clinic visit.
- At baseline, patients underwent echocardiography, which was used to evaluate LV mass index and define LVH by sex-specific thresholds. Comorbidities and antihypertensive regimens were also recorded.
TAKEAWAY:
- The average nighttime systolic BP was 110.5 mm Hg, and 29.6% of patients had nocturnal hypertension (nighttime BP ≥ 120/70 mm Hg). Overall, 15.6% of patients had LVH, with a higher prevalence in women than in men (20.6% vs 11.3%; P < .001).
- Each 10-mm Hg increase in nighttime systolic BP was associated with a 2.44 g/m2 increase in LV mass index (P < .001), independent of factors including office and morning systolic BP.
- Each 10-mm Hg increase in nighttime systolic BP was independently linked to 36% increased odds of LVH overall, 54% in men, and 27% in women (P < .05 for all). The percentages were adjusted for clinical covariates including office and morning home BP.
- The threshold for nighttime systolic BP associated with higher odds of LVH differed by sex (≥ 120 mm Hg in men and ≥ 100 mm Hg in women). Uncontrolled home BP was associated with the risk for LVH among patients on three or more antihypertensive drugs, whereas office BP showed no significant association with the risk for LVH.
IN PRACTICE:
“Integrating nighttime home BP control assessed by user-friendly home devices into routine clinical practice may represent a new direction for optimizing hypertension management,” the researchers wrote.
SOURCE:
The study was led by Kazuomi Kario, MD, PhD, of Jichi Medical University School of Medicine in Shimotsuke. It was published online on May 11 in Hypertension.
LIMITATIONS:
About 80% of patients had well-controlled nighttime systolic BP, which may have underestimated its link to LV changes. The study excluded shift workers or those who did not sleep between 2:00 and 4:00 AM. The cross-sectional design of the study prevented the derivation of any causal conclusions.
DISCLOSURES:
The study received support in part from Omron Healthcare Co., Ltd. One author reported receiving research grants from Omron Healthcare, A&D Co., Ltd., and Fukuda Denshi Co., Ltd. The study was coordinated by the Super Circulation Monitoring with High Technology R&D Center, a joint research center between Jichi Medical University School of Medicine and Omron Healthcare, although employees of Omron Healthcare were not involved in analyzing results.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
