Repeated evening home blood pressure measurement improves prognostic significance for stroke: A 12-year follow-up of the ohasama study

Kei Asayama, Takayoshi Ohkubo, Azusa Hara, Takuo Hirose, Daisaku Yasui, Taku Obara, Hirohito Metoki, Ryusuke Inoue, Masahiro Kikuya, Kazuhito Totsune, Haruhisa Hoshi, Hiroshi Satoh, Yutaka Imai

Research output: Contribution to journalArticlepeer-review

15 Citations (Scopus)


Objective To compare the predictive power of home blood pressure (HBP) measured in the evening (E-HBP) and that of casual screening BP (CBP) for stroke risk in relation to the number of E-HBP measurements. Methods We obtained E-HBP (measured once in the evening just before going to bed for 4 weeks) and CBP (measured twice during the health checkup) from 2234 Japanese participants aged ^ 35 years who had no history of a previous stroke. The participants were followed-up for a median duration of 11.9 years. The multivariate adjusted relative hazard (RH) and 95% confidence intervals (CI) for each 10mmHg (systolic) or 5mmHg (diastolic) increase in BP was determined by Cox regression model. Results There were 226 incidences of stroke. Even the initial E-HBP values significantly predicted future stroke events (systolic RH = 1.19. 95% CI = 1.11-1.28; diastolic RH = 1.12. 95% CI = 1.06-1.19). and the predictive power of E-HBP increased progressively with the increased number of measurements. When initial systolic E-HBP and systolic CBP values were simultaneously included into the Cox model. only initial E-HBP was significantly related with stroke risk (E-HBP RH = 1.17. 95% CI = 1.08-1.26; CBP RH = 1.07. 95% CI=0.99-1.15). Conclusion E-HBP has a stronger predictive power than CBP regardless of the number of measurements. Our findings emphasize the important clinical significance of E-HBP over CBP. even though the measurement conditions of E-HBP are generally less strict than that of morning HBP measurements.

Original languageEnglish
Pages (from-to)93-98
Number of pages6
JournalBlood Pressure Monitoring
Issue number3
Publication statusPublished - 2009 Jun
Externally publishedYes


  • Evening home blood pressure
  • General population
  • Home blood pressure
  • Measurement number
  • Ohasama study
  • Stroke

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine
  • Assessment and Diagnosis
  • Advanced and Specialised Nursing


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