Journal
AMERICAN JOURNAL OF HYPERTENSION
Volume 35, Issue 4, Pages 328-336Publisher
OXFORD UNIV PRESS
DOI: 10.1093/ajh/hpab177
Keywords
blood pressure; blood pressure monitoring; cohort studies; epidemiology; home blood pressure; hypertension; prognosis
Categories
Funding
- Grants for Scientific Research, Ministry of Education, Culture, Sports, Science and Technology, Japan [17H04126, 17K15853, 17K19930, 18K09674, 18K09904, 18K17396, 19K19466, 19H03908, 19K10662, 20K08612, 21K10452, 21K10478, 21H04854, 21K17313, 21K19670]
- Keio University
- Japan Arteriosclerosis Prevention Fund
- Ministry of Health, Labor, and Welfare, Japan [H29-Junkankitou-Ippan-003, 20FA1002]
- ACRO Incubation Grants of Teikyo University
- Daiichi Sankyo
- Astellas Pharma
- Chugai Pharmaceutical
- Takeda Pharmaceutical
- Health Care Science Institute Research Grant
- Health Science Centre Research Grant
- Takeda Science Foundation
- Grants-in-Aid for Scientific Research [21K10452, 21K10478, 20K08612, 19H03908, 19K10662, 19K19466, 18K09904, 17K19930, 18K09674, 18K17396, 17K15853, 17H04126, 21H04854, 21K17313, 21K19670] Funding Source: KAKEN
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The study aimed to develop risk prediction models for new-onset home morning hypertension, concluding that the full model demonstrated good predictive ability for 5- and 10-year home hypertension. Additionally, the inclusion of home systolic blood pressure is crucial for accurately predicting home morning hypertension.
Background We aimed to develop risk prediction models for new-onset home morning hypertension. Methods We followed up 978 participants without home hypertension in the general population of Ohasama, Japan (men: 30.1%, age: 53.3 years). The participants were divided into derivation (n = 489) and validation (n = 489) cohorts by their residential area. The C-statistics and calibration plots were assessed after the 5- or 10-year follow-up. Results In the derivation cohort, sex, age, body mass index, smoking, office systolic blood pressure (SBP), and home SBP at baseline were selected as significant risk factors for new-onset home hypertension (>= 135/85 mm Hg or the initiation of antihypertensive treatment) using the Cox model. In the validation cohort, Harrell's C-statistic for the 5-/10-year home hypertension was 0.7637 (0.7195-0.8100)/0.7308 (0.6932-0.7677), when we used the full model, which included the significant risk factors in the derivation cohort. The calibration test revealed good concordance between the observed and predicted 5-/10-year home hypertension probabilities (P >= 0.19); the regression slope of the observed probability on the predicted probability was 1.10/1.02, and the intercept was -0.04/0.06, respectively. A model without home SBP was also developed; for the 10-year home hypertension risk, the calibration test revealed a good concordance (P = 0.19) but Harrell's C-statistic was 0.6689 (0.6266-0.7067). Conclusions The full model revealed good ability to predict the 5- and 10-year home morning hypertension risk. Although the model without home SBP is acceptable, the low C-statistic implies that home BP should be measured to predict home morning hypertension precisely.
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