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Home blood pressure stability score is associated with better cardiovascular prognosis: data from the nationwide prospective J-HOP study

Hypertension Research volume 48, pages 604–612 (2025)Cite this article

A Comment to this article was published on 14 November 2024

Abstract

A home blood pressure (BP)-centered strategy is emerging as the optimal approach to achieve adequate BP control in individuals with hypertension, but a simple cardiovascular risk score based on home BP level and variability is lacking. This study used prospective data from the Japan Morning Surge-Home Blood Pressure (J-HOP) extended study to develop a simple home BP stability score for the prediction of cardiovascular risk. The J-HOP extended study included 4070 participants (mean age 64.9 years) who measured home BP three times in the morning and evening for 14 days at baseline. During the mean 6.3-year follow-up, there were 260 cardiovascular events. A home BP stability score was calculated based on the average of morning and evening systolic BP (SBP; MEave), and three home BP variability metrics: average real variability (average absolute difference between successive measurements); average peak (average of the highest three SBP values for each individual), and time in therapeutic range (proportion of time spent with MEave home SBP 100–135 mmHg). There was a curvilinear association between the home BP stability score and the risk of cardiovascular events. Compared with individuals in the optimal home SBP stability score group (9–10 points), those in the very high-risk group (0 points) had significantly higher cardiovascular event risk during follow-up (adjusted hazard ratio 3.97, 95% confidence interval 2.22–7.09; p < 0.001), independent of age, sex, medication, cardiovascular risk factors, and office BP. These data show the potential for a simple home BP-based score to predict cardiovascular event risk in people with hypertension.

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Acknowledgements

Medical writing support was provided by Nicola Ryan, independent medical writer, and by Noriko Harada, English publication coordinator, funded by Jichi Medical University.

Funding

This study was financially supported in part by a grant from the Foundation for the Development of the Community (Tochigi).

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Authors and Affiliations

  1. Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan

    Kazuomi Kario, Hiroshi Kanegae & Satoshi Hoshide

  2. Genki Plaza Medical Center for Health Care, Tokyo, Japan

    Hiroshi Kanegae

Authors
  1. Kazuomi Kario
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  2. Hiroshi Kanegae
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  3. Satoshi Hoshide
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Contributions

Study conception and design: KK, SH. Data preparation: KK and SH. Data analysis: HK. Data interpretation: all authors. Drafting and revising of the manuscript: KK and HK. Final approval of the submitted manuscript: all authors.

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Correspondence to Kazuomi Kario.

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KK has received research funding from Omron Healthcare Co, Fukuda Denshi, and A&D Co. Ltd. None of the other authors have any conflicts of interest to disclose.

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Kario, K., Kanegae, H. & Hoshide, S. Home blood pressure stability score is associated with better cardiovascular prognosis: data from the nationwide prospective J-HOP study. Hypertens Res 48, 604–612 (2025). https://doi.org/10.1038/s41440-024-01940-z

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