Prediction Models for the 5- and 10-Year Incidence of Home Morning Hypertension: The Ohasama Study

Michihiro Satoh, Hirohito Metoki, Kei Asayama, Masahiro Kikuya, Takahisa Murakami, Yukako Tatsumi, Azusa Hara, Megumi Tsubota-Utsugi, Takuo Hirose, Ryusuke Inoue, Kyoko Nomura, Atsushi Hozawa, Yutaka Imai, Takayoshi Ohkubo

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)328-336
Number of pages9
JournalAmerican journal of hypertension
Issue number4
Publication statusPublished - 2022 Apr 1


  • blood pressure
  • blood pressure monitoring
  • cohort studies
  • epidemiology
  • home blood pressure
  • hypertension
  • prognosis

ASJC Scopus subject areas

  • Internal Medicine


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