Abstract:
BACKGROUND:How far should blood pressure (BP) be lowered to achieve the greatest reduction in the risk of cardiovascular disease? Although a few trials have tried to answer this question, they failed to convincingly establish an optimal target BP level, in part because of poor reproducibility and the wide variability of conventional casual BP measurement they used. At the same time, in Japan, calcium antagonist (Ca-A) and angiotensin-converting enzyme inhibitor (ACE-I) have been two major medications in initial therapy for hypertension, while angiotensin II receptor antagonist (ARB), which has recently been introduced, is also now used widely as an initial therapy. However, no large-scale interventional trial has been conducted to show which of these three initial medications can give the greatest benefit in reducing the risk of cardiovascular disease in the Japanese hypertensive patient. OBJECTIVE:The objectives of the study are, first, to determine an optimal target BP level, based on BP values self-measured at home (home BP). This way of measurement provides more reproducible and less variable BP values than conventional casual measurements. Secondly, we seek to determine the optimal initial antihypertensive medication for the Japanese hypertensive population. METHOD:The study is a 2 x 3 factorial randomized controlled trial conducted with a prospective randomized open-blinded endpoint design. The study will include a total of 9000 untreated essential hypertensive patients aged 40 to 78 years with home BP values > or = 135/85 mmHg. Eligible patients are randomized to one of the two home BP target groups (systolic/diastolic home BP within the range of 134-125/84-80 mmHg, or > or = 125/80 mmHg), and to regimens based on one of three initial antihypertensive drugs (Ca-A or ACE-I or ARB). These randomizations, performed by our host computer, are transmitted to terminals at the outpatient clinic through the Internet. The patient measures BP at home with newly developed equipment (HEM-7471C-N; Omron, Japan) that records BP values, the date, and the time of each measurement. The data are downloaded to the outpatient terminal at every clinic visit then transmitted to the host computer via the Internet. Based on these home BP values, the host computer determines the necessity of additional therapy or dose increments in four further steps to reach the randomized target BP, and then transmits the information to the terminal at the outpatient clinic. The primary study outcome is a composite of non-fatal stroke, non-fatal myocardial infarction, and cardiovascular death. The scheduled average post-randomization duration of follow-up is 7 years. CONCLUSION:This is the first large-scale home BP-based and Internet-connected intervention trial on antihypertensive treatment. The HOMED-BP study (Hypertension Objective treatment based on Measurement by Electrical Devices of BP) will improve the recruitment of general practitioners and participants and will supply unbiased BP data, providing reliable information on optimal target BP levels and the optimal initial antihypertensive medication.
journal_name
Blood Press Monitjournal_title
Blood pressure monitoringauthors
Fujiwara T,Nishimura T,Ohkuko T,Imai Y,HOMED-BP Study Group.doi
10.1097/00126097-200202000-00016subject
Has Abstractpub_date
2002-02-01 00:00:00pages
77-82issue
1eissn
1359-5237issn
1473-5725journal_volume
7pub_type
临床试验,杂志文章,随机对照试验abstract:OBJECTIVE:We evaluated the Tiba Medical Ambulo 2400 ambulatory blood pressure monitor accuracy by both the International Standards Organization (ISO) Standard and the British Hypertension Society (BHS) protocol. METHODS:We tested children, adolescents, and adults. The requirements for both ISO and BHS were completed f...
journal_title:Blood pressure monitoring
pub_type: 杂志文章
doi:10.1097/MBP.0b013e32833c8b39
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:Measuring blood pressure with mercury-independent alternatives is rapidly gaining attention. Mercury will be phased out of clinical use as a result of environmental, health and safety concerns and it is of vital importance that any alternative to mercury has to be of a recognized standard. We assessed the ac...
journal_title:Blood pressure monitoring
pub_type: 杂志文章
doi:10.1097/00126097-200304000-00005
更新日期:2003-04-01 00:00:00
abstract::BACKGROUND: Hypertension is responsible for substantial morbidity in end-stage renal disease. Ambulatory blood pressure monitoring has been used to understand the behavior of blood pressure in renal failure, especially during the interdialytic period for patients on hemodialysis. OBJECTIVE: To review the published dat...
journal_title:Blood pressure monitoring
pub_type: 杂志文章
doi:
更新日期:1997-12-01 00:00:00
abstract:OBJECTIVE:To compare readings obtained using two automated blood pressure (BP) recording devices, BpTRU and Omron 907, in a clinical setting. METHODS:Two series of 50 patients attending a hypertension unit for 24-h ambulatory BP monitoring had BP recorded either every 1 or every 2 min using BpTRU and Omron 907 devices...
journal_title:Blood pressure monitoring
pub_type: 杂志文章
doi:10.1097/MBP.0b013e32831e314f
更新日期:2009-02-01 00:00:00
abstract::Sudden cardiac death, myocardial infarction, unstable angina, ventricular tachyarrhythmias, fatal pulmonary thromboembolism, rupture of thoracic aorta, and ischemic and hemorrhagic cerebrovascular accidents exhibit a prominent circadian pattern with events more frequently during the morning (0600-1200 h)after awakenin...
journal_title:Blood pressure monitoring
pub_type: 杂志文章
doi:
更新日期:1998-02-01 00:00:00
abstract:OBJECTIVE:Psoriasis is a chronic inflammatory disorder, which is associated with high risk of metabolic comorbidities. Hypertension (HTN) is among the most common and serious associations. In this study, we aimed to evaluate HTN in psoriatic patients through office and ambulatory blood pressure monitoring (ABPM). MATE...
journal_title:Blood pressure monitoring
pub_type: 杂志文章
doi:10.1097/MBP.0000000000000489
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:In acute ischemic stroke, a transient elevation of blood pressure is common; its significance and its relationship with the neurological outcome are still unclear. METHODS:In 71 consecutive patients with acute ischemic stroke, aged 25-94 years, admitted to our unit, we investigated the relationships between...
journal_title:Blood pressure monitoring
pub_type: 杂志文章
doi:10.1097/01.mbp.0000209077.23084.93
更新日期:2006-08-01 00:00:00
abstract::OBJECTIVE: To assess the spontaneous changes in clinic blood pressure, ambulatory blood pressure (ABP) and left ventricular structure in untreated subjects with white-coat hypertension (WCH). DESIGN: A prospective observational study. PATIENTS AND METHODS: In 83 untreated subjects with WCH, 24 h non-invasive ABP monit...
journal_title:Blood pressure monitoring
pub_type: 杂志文章
doi:
更新日期:1996-06-01 00:00:00
abstract:OBJECTIVE:Current guidelines for office blood pressure (BP) measurement recommend mercury devices, both arms measurement in the initial assessment and at least duplicate measurements at follow-up visits. This study presents the design and a pilot application study of an automated device that fulfils American, European,...
journal_title:Blood pressure monitoring
pub_type: 杂志文章
doi:10.1097/MBP.0b013e3283057a84
更新日期:2008-08-01 00:00:00
abstract::The acute effect of smoking is a rise in blood pressure and heart rate. Nevertheless, in several epidemiologic studies, smokers tend to have a slightly lower office blood pressure than non-smokers. We studied the 24 h ambulatory blood pressure consecutively in hypertensive smokers (> or = 10 cigarettes per day, n = 26...
journal_title:Blood pressure monitoring
pub_type: 杂志文章
doi:10.1097/00126097-200010000-00004
更新日期:2000-10-01 00:00:00
abstract:BACKGROUND:Self-measurements of blood pressure may offer some advantage in diagnostic and therapeutic evaluation and in management of patients. However, the most important limitation of self-measurement is that there are limited data available about the prognostic value of this information. RESULTS:Authors of several ...
journal_title:Blood pressure monitoring
pub_type: 共识发展会议,杂志文章,评审
doi:
更新日期:2000-04-01 00:00:00
abstract:BACKGROUND:Arterial hypertension is associated with cardiovascular morbidity and mortality. It was previously shown that left atrium volume increase associated with mortality and atherosclerotic heart disease. The aim of the present study was to demonstrate the value of endothelial dysfunction in predicting left atrium...
journal_title:Blood pressure monitoring
pub_type: 杂志文章
doi:10.1097/MBP.0000000000000419
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVES:The objective of this work was to test the hypothesis that the Finapres underestimates blood pressure during sympathetic peripheral vasoconstriction. METHODS:Measurements were made simultaneously with two Finapres devices and one radial artery tonometer during the onset of periodic lower body negative press...
journal_title:Blood pressure monitoring
pub_type: 临床试验,杂志文章
doi:10.1097/MBP.0b013e3282c9acc3
更新日期:2007-10-01 00:00:00
abstract:OBJECTIVE:There is a growing tendency for physicians to prescribe exercise in accordance with the 'exercise is medicine' global health initiative. However, the exercise-pharmacologic interactions for controlling blood pressure are not well described. Our purpose was to study whether angiotensin II receptor type 1 block...
journal_title:Blood pressure monitoring
pub_type: 杂志文章,随机对照试验
doi:10.1097/MBP.0000000000000328
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Background Ambulatory blood pressure monitoring (ABPM) has been shown to be more representative of blood pressure levels in adult patients than are casual measurements of blood pressure. OBJECTIVE:To evaluate, by means of ABPM, the behavior of blood pressure in children with chronic renal failure submitted ...
journal_title:Blood pressure monitoring
pub_type: 杂志文章
doi:
更新日期:1999-10-01 00:00:00
abstract:OBJECTIVES:The nondipper pattern in hypertension is associated with worse cardiovascular outcomes. In this study, we hypothesized that high copeptin levels could predict nondippers among hypertensive patients and investigated the associations between copeptin levels and nondipper pattern in newly diagnosed hypertensive...
journal_title:Blood pressure monitoring
pub_type: 临床试验,杂志文章
doi:10.1097/MBP.0000000000000123
更新日期:2015-08-01 00:00:00
abstract::OBJECTIVE: To test a semi-automatic oscillometric blood pressure measurement device with a wrist cuff. METHODS: Two different test methods, partly based on European and American standards for clinical investigation of non-invasive sphygmomanometers, were worked out and compared. Mostly German guidelines were considere...
journal_title:Blood pressure monitoring
pub_type: 杂志文章
doi:
更新日期:1996-08-01 00:00:00
abstract:OBJECTIVE:To analyze whether the number of blood pressure registrations per hour and/or different ways of defining day and night have any influence on the result of ambulatory blood pressure monitoring. DESIGN AND METHODS:The study used blood pressure data from 40 normotensive subjects (20 men) and 40 (20 men) treated...
journal_title:Blood pressure monitoring
pub_type: 杂志文章
doi:10.1097/00126097-200110000-00005
更新日期:2001-10-01 00:00:00
abstract:OBJECTIVE:We have shown that as renal function deteriorates, the circadian blood pressure (BP) rhythm shifts to a nondipper pattern and the duration until nocturnal BP decline [dipping time (DT)] is prolonged. We investigated whether or not morning hypertension (BP 2 h after awakening >135/85 mmHg) in chronic kidney di...
journal_title:Blood pressure monitoring
pub_type: 杂志文章
doi:10.1097/MBP.0b013e32835026c6
更新日期:2012-02-01 00:00:00
abstract::OBJECTIVE: To test the SpaceLabs Medical 90217 ambulatory blood pressure monitor for compliance with The Association for the Advancement of Medical Instrumentation's standard and a modification of the British Hypertension Society (BHS) protocol. METHODS: The study concerned 85 subjects aged 17-88 years with various ar...
journal_title:Blood pressure monitoring
pub_type: 杂志文章
doi:
更新日期:1998-10-01 00:00:00
abstract:OBJECTIVE:The independent prognostic significance of ambulatory blood pressure variability in the elderly is incompletely clear. We investigated the prognostic value of average real variability of 24-hour blood pressure in elderly treated hypertensive patients. METHODS:The occurrence of a combined end-point including ...
journal_title:Blood pressure monitoring
pub_type: 杂志文章
doi:10.1097/MBP.0000000000000381
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVE:To perform validation for an arm-type oscillometric TM-2655 device (A&D Company Ltd, Tokyo, Japan) for blood pressure measurement according to the British Hypertension Society protocol. METHODS:Eighty-five study participants (33 men and 52 women) were included in the study. Mean age was 52.9+/-15.0 years, sy...
journal_title:Blood pressure monitoring
pub_type: 杂志文章
doi:10.1097/01.mbp.0000200484.49540.12
更新日期:2006-04-01 00:00:00
abstract::Although self-measured blood pressure and ambulatory blood pressure are widely used for research and clinical purposes, reference values are still scarcely supported by prospective outcome data. For self-measured blood pressure, values of 135 mmHg systolic and 85 mmHg diastolic (an average of two measurements in the m...
journal_title:Blood pressure monitoring
pub_type: 杂志文章,评审
doi:10.1097/00126097-200112000-00011
更新日期:2001-12-01 00:00:00
abstract:BACKGROUND:Patients with high office blood pressures but relatively normal readings during daytime ambulatory monitoring have been the subject of much investigation and debate. This clinical finding in part depends on an alerting reaction to the circumstances of the clinical measurement, often described as the 'white-c...
journal_title:Blood pressure monitoring
pub_type: 杂志文章
doi:
更新日期:2000-04-01 00:00:00
abstract::Thomas G. Pickering spent most of his scientific career in carrying out research on clinical hypertension and blood pressure (BP) measurement. In our review of Pickering's seminal work, we first focused on white-coat hypertension and masked hypertension, two terms that he had introduced. Next, we highlighted the early...
journal_title:Blood pressure monitoring
pub_type: 传,历史文章,杂志文章
doi:10.1097/MBP.0b013e3283380e1e
更新日期:2010-04-01 00:00:00
abstract:BACKGROUND:Guidelines for office blood pressure reading techniques do not warn us about the possibility that patients may clench their fist during cuff-inflation. It is unknown how often patients do this, and what effect it has on measured blood pressure readings. DESIGN AND METHODS:We registered double blood pressure...
journal_title:Blood pressure monitoring
pub_type: 杂志文章
doi:10.1097/00126097-200206000-00001
更新日期:2002-06-01 00:00:00
abstract:BACKGROUND:The Keito machine offers automatic measurements of blood pressure (BP), height and weight on insertion of coins and has been introduced in pharmacies. DESIGN:Cross-sectional study comparing automatic BP measurements by the Keito machine to office BP measurements by physicians. METHODS:Patients scheduled fo...
journal_title:Blood pressure monitoring
pub_type: 杂志文章
doi:10.1097/01.mbp.0000130223.80658.3d
更新日期:2004-06-01 00:00:00
abstract:OBJECTIVE:The aim of the present study was to evaluate the accuracy of the automated oscillometric wrist blood pressure monitor AVITA BPM17 for home blood pressure monitoring according to the International Protocol of the European Society of Hypertension revision 2010. PARTICIPANTS AND METHODS:Systolic and diastolic b...
journal_title:Blood pressure monitoring
pub_type: 杂志文章
doi:10.1097/MBP.0000000000000261
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVES:To determine blood pressure (BP) reassessment rates and to describe the evaluation and outpatient referral rates of elderly emergency department (ED) patients with elevated BP. METHODS:This was a retrospective cohort of patients who were at least 60 years, presented with a systolic BP of at least 140 mmHg o...
journal_title:Blood pressure monitoring
pub_type: 杂志文章,多中心研究
doi:10.1097/MBP.0b013e328332fd40
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:The study investigated the clinical significance of relatively high blood pressure (BP) elevations during the calibration of the ambulatory blood pressure monitor (ABPM). METHODS:Inferences were drawn from the analysis of differences between 'M', the average of five manually triggered responses, and 'W', th...
journal_title:Blood pressure monitoring
pub_type: 杂志文章
doi:10.1097/MBP.0b013e328340ff51
更新日期:2011-02-01 00:00:00