Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Clin Hypertens (Greenwich). 2018 Dec;20(12):1686-1695. doi: 10.1111/jch.13415. Epub 2018 Nov 16.
A self-measured home blood pressure (BP)-guided strategy is an effective practical approach to hypertension management. The Asia BP@Home study is the first designed to investigate current home BP control status in different Asian countries/regions using standardized home BP measurements taken with the same validated home BP monitoring device with data memory. We enrolled 1443 medicated hypertensive patients from 15 Asian specialist centers in 11 countries/regions between April 2017 and March 2018. BP was relatively well controlled in 68.2% of patients using a morning home systolic BP (SBP) cutoff of <135 mm Hg, and in 55.1% of patients using a clinic SBP cutoff of <140 mm Hg. When cutoff values were changed to the 2017 AHA/ACC threshold (SBP <130 mm Hg), 53.6% of patients were well controlled for morning home SBP. Using clinic 140 mm Hg and morning home 135 mm Hg SBP thresholds, the proportion of patients with well-controlled hypertension (46%) was higher than for uncontrolled sustained (22%), white-coat (23%), and masked uncontrolled (9%) hypertension, with significant country/regional differences. Home BP variability in Asian countries was high, and varied by country/region. In conclusion, the Asia BP@Home study demonstrated that home BP is relatively well controlled at hypertension specialist centers in Asia. However, almost half of patients remain uncontrolled for morning BP according to new guidelines, with significant country/regional differences. Strict home BP control should be beneficial in Asian populations. The findings of this study are important to facilitate development of health policies focused on reducing cardiovascular complications in Asia.
自我测量的家庭血压(BP)指导策略是管理高血压的一种有效实用方法。亚洲 BP@Home 研究是首次旨在使用相同的经过验证的具有数据存储功能的家庭血压监测设备进行标准化家庭血压测量,调查不同亚洲国家/地区当前的家庭血压控制状况。我们于 2017 年 4 月至 2018 年 3 月期间在 11 个国家/地区的 15 个亚洲专科中心共招募了 1443 名接受药物治疗的高血压患者。使用早晨家庭收缩压(SBP)<135mmHg 的切点,68.2%的患者血压控制较好,使用诊所 SBP<140mmHg 的切点,55.1%的患者血压控制较好。当切点值更改为 2017 年 AHA/ACC 阈值(SBP<130mmHg)时,53.6%的患者早晨家庭 SBP 控制良好。使用诊所 140mmHg 和早晨家庭 135mmHg SBP 阈值,血压控制良好的高血压患者(46%)比例高于未控制的持续性(22%)、白大衣(23%)和隐匿性未控制(9%)高血压患者,存在显著的国家/地区差异。亚洲国家的家庭血压变异性较高,且因国家/地区而异。总之,亚洲 BP@Home 研究表明,亚洲高血压专科中心的家庭血压控制相对较好。然而,根据新指南,近一半的患者早晨血压仍未得到控制,且存在显著的国家/地区差异。严格的家庭血压控制对亚洲人群可能有益。本研究结果对于制定关注亚洲心血管并发症减少的卫生政策具有重要意义。