Home Blood Pressure and Preclinical Organ Damage
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We reviewed the literature regarding current evidence about associations between home blood pressure (BP) and preclinical target organ damage. Previous studies have identified associations between home BP values and various types of preclinical target organ damage, such as left ventricular hypertrophy (LVH), carotid atherosclerosis including carotid intima-media thickness and carotid plaque, renal function including urinary protein excretion and glomerular filtration rate, and pulse wave velocity or silent cerebrovascular lesions. Although the strength of these associations has been compared between home and conventional office BP values, and a closer association between home BP and LVH has been established, the findings are inconsistent and/or limited to identifying a closer association between home BP and preclinical organ damage other than LVH. Masked hypertension (MHT) is a subtype of hypertension characterized by BP values not showing hypertension in the office but being in the hypertensive range when measured out of the office. Few studies have examined the association between MHT determined by self-measured BP at home and preclinical target organ damage. Nonetheless, all of them identified significantly higher risk of preclinical target organ damage in patients with MHT than in individuals with normal BP values. These findings altogether indicate that individuals with advanced preclinical target organ damage and normal office BP values should measure their BP at home for the early detection of MHT.
KeywordsHypertension Blood pressure measurement Home blood pressure Preclinical target organ damage Masked hypertension
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