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Diagnostic Value of Home Blood Pressure

  • Kazuomi KarioEmail author
  • Yutaka Imai
  • Anastasios Kollias
  • Teemu J. Niiranen
  • Takayoshi Ohkubo
  • Richard J. McManus
  • George S. Stergiou
Chapter
Part of the Updates in Hypertension and Cardiovascular Protection book series (UHCP)

Abstract

Home blood pressure (BP) monitoring is a more accurate diagnostic modality for hypertension than office BP measurement. Nonetheless, home BP measurement (HBPM) must be performed at specific times (morning and evening) under specific conditions (e.g., with the subject at rest), and thus it is of limited use for detecting various forms of masked hypertension, such as daytime ambulatory hypertension and nighttime hypertension, which are better detected by ambulatory BP monitoring (ABPM). Indeed, if we use the same threshold of 135/85 mmHg for the diagnosis of hypertension by both HBPM and daytime ABPM, we find that HBPM misdiagnoses a significant number of cases of masked hypertension. On the other hand, HBPM has the important advantage of including a greater number of BP readings due to the use of repeated home measurements. In addition, out-of-office BP is not stable, but rather changes with the various day-by-day individual and environmental conditions. The diagnosis of hypertension and uncontrolled hypertension on medication, which is affected by real-world stressors and other conditions, could be detected more immediately by repeated self-measured HBPM than by the intermittent measurements used for office and/or ABPM.

Keywords

Home blood pressure monitoring Diagnostic value Day-by-day variability Masked hypertension White-coat hypertension 

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Copyright information

© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG, part of Springer Nature 2020

Authors and Affiliations

  • Kazuomi Kario
    • 1
    Email author
  • Yutaka Imai
    • 2
  • Anastasios Kollias
    • 3
  • Teemu J. Niiranen
    • 4
    • 5
  • Takayoshi Ohkubo
    • 2
    • 6
  • Richard J. McManus
    • 7
  • George S. Stergiou
    • 3
  1. 1.Division of Cardiovascular Medicine, Department of MedicineJichi Medical University School of Medicine (JMU)TochigiJapan
  2. 2.Tohoku Institute for Management of Blood PressureSendaiJapan
  3. 3.Hypertension Center STRIDE-7National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria HospitalAthensGreece
  4. 4.Department of Public Health SolutionsNational Institute for Health and WelfareTurkuFinland
  5. 5.Department of MedicineTurku University Hospital and University of TurkuTurkuFinland
  6. 6.Department of Hygiene and Public HealthTeikyo University School of MedicineTokyoJapan
  7. 7.Nuffield Department of Primary Care Health SciencesUniversity of Oxford, Radcliffe Observatory QuarterOxfordUK

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