Factors associated with day-by-day variability of self-measured blood pressure at home: The ohasama study

Tetsuo Kato, Masahiro Kikuya, Takayoshi Ohkubo, Michihiro Satoh, Azusa Hara, Taku Obara, Hirohito Metoki, Kei Asayama, Takuo Hirose, Ryusuke Inoue, Atsuhiro Kanno, Kazuhito Totsune, Haruhisa Hoshi, Hiroshi Satoh, Yutaka Imai

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53 Citations (Scopus)


Background We previously reported that high day-by-day blood pressure (BP) variability derived from self-measured BP at home (home BP) predicted cardiovascular mortality over and beyond other risk factors. The objective of this study is to clarify the determinants of the day-by-day home-BP variability. Methods We conducted a cross-sectional community survey in 1,215 inhabitants (female gender 59%, mean age 62 years) of Ohasama, Japan. The subjects measured their BP and heart rate once every morning and once every evening for 4 weeks. The day-by-day BP variability and heart rate variability were defined as within individual standard deviation of all home BP and heart rate, respectively. We also considered coefficient of variation (CV). These parameters in the morning and those in the evening were calculated separately. Results The level and standard deviation of home systolic/diastolic BP (SBP/DBP) in the morning were 123.4±15.1/75.7±9.0mmHg and 8.6±3.1/5.8±2.0mmHg. Multivariate linear regression analysis demonstrated that older age, female gender, elevated home BP, low home heart rate, and elevated home heart rate variability were significant determinants of elevated home-BP variability. In addition to these factors, alcohol intake and sedentary lifestyle were also determinants of elevated home-BP variability in the evening. Conclusions Day-by-day home-BP variability was associated with home BP, alcohol intake or sedentary lifestyle. Whether modifying these factors would reduce BP variability and whether such reduction would lead to better outcomes needs further study.

Original languageEnglish
Pages (from-to)980-986
Number of pages7
JournalAmerican journal of hypertension
Issue number9
Publication statusPublished - 2010 Sept
Externally publishedYes


  • blood pressure
  • blood pressure measurement/monitoring
  • epidemiology
  • hypertension
  • population science
  • risk factors

ASJC Scopus subject areas

  • Internal Medicine


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