Difference in evening home blood pressure between before dinner and at bedtime in Japanese elderly hypertensive patients

• Published in: The journal of clinical hypertension (Greenwich, Conn.) Vol. 19; no. 7; pp. 731 - 739
• Main Authors: Fujiwara, Takeshi, Hoshide, Satoshi, Nishizawa, Masafumi, Matsuo, Takefumi, Kario, Kazuomi
• Format: Journal Article
• Language: English
• Published: United States John Wiley and Sons Inc 01.07.2017
• Subjects: Adult; Aged; Aged, 80 and over; alcohol consumption; Alcohol Drinking - adverse effects; Alcohol Drinking - physiopathology; Antihypertensive Agents - therapeutic use; bathing; Baths - adverse effects; Blood Pressure - drug effects; Blood Pressure - physiology; Blood Pressure Determination - methods; Blood Pressure Monitoring, Ambulatory - methods; Blood Pressure Studies; Circadian Rhythm - physiology; evening home blood pressure; Female; Guidelines as Topic; Humans; Hypertension - diagnosis; Hypertension - drug therapy; Hypertension - physiopathology; hypertension guideline; Japan - epidemiology; Male; Meals - physiology; Middle Aged; Original Paper; Time Factors; evening home blood pressure; bathing; alcohol consumption; hypertension guideline
• ISSN: 1524-6175; 1751-7176
• DOI: 10.1111/jch.12985

The authors evaluated the differences between evening home blood pressure (HBP) readings taken before dinner and those taken at bedtime, which were documented in a European and a Japanese guideline, respectively. Forty‐eight patients (mean age, 76.4 years) measured their evening HBP twice each day (two measurements both before dinner and at bedtime) for 14 days. The authors defined the at‐bedtime (B) minus the before‐dinner (D) systolic HBP as the B‐D difference. The mean B‐D difference was −8.7 mm Hg (P<.001). The depressor effect of bathing was significantly prolonged for 120 minutes. The B‐D difference with alcohol consumption was significantly greater than that without alcohol. In the linear mixed model analysis, time after bathing ≤120 minutes and alcohol consumption were significantly associated with the B‐D difference after adjustment with covariates. There was a marked difference between evening HBP values. When patients' evening HBP is measured according to the guidelines, their daily activities should be considered.