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Comment on “Peak nocturnal home blood pressure as an early and strong novel risk factor for stroke: the practitioner-based nationwide J-HOP Nocturnal BP study”

Hypertension Research (2025)Cite this article

Dear Editor,

We read with great interest the recent article by Kario et al. entitled “Peak nocturnal home blood pressure as an early and strong novel risk factor for stroke: the practitioner-based nationwide J-HOP Nocturnal BP study” published in Hypertension Research [1]. The investigators provide compelling evidence that peak nocturnal home systolic blood pressure (SBP)—defined as the average of the three highest readings across a 14-day period—is a robust predictor of stroke risk, independent of office, morning, evening, and mean nighttime BP. With a mean follow-up of 7.1 years, participants in the highest quintile (≥149 mmHg) exhibited more than fourfold higher risk of stroke compared with those in the lowest quintile, and the association strengthened when analyses were restricted to individuals with ≥6 nighttime readings. Spline regression identified 136 mmHg as a practical cut-off. These findings move risk assessment beyond mean values, highlighting the prognostic relevance of extreme nocturnal surges.

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References

  1. Kario K, Okawara Y, Kanegae H, Tomitani N, Hoshide S. Peak nocturnal home blood pressure as an early and strong novel risk factor for stroke: the practitioner-based nationwide J-HOP Nocturnal BP study. Hypertens Res. 2025;48:622–31. https://doi.org/10.1038/s41440-024-01866-6.

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Acknowledgements

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Funding

Key Research and Development Program of Xingtai (2023ZC083).

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Authors and Affiliations

  1. Department of Neurology, Xingtai Central Hospital, Hebei, China

    Jingman Wang, Lijuan Wu, Qiuyue Wang & Keke Wang

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  1. Jingman Wang
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  2. Lijuan Wu
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  3. Qiuyue Wang
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  4. Keke Wang
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Correspondence to Keke Wang.

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Wang, J., Wu, L., Wang, Q. et al. Comment on “Peak nocturnal home blood pressure as an early and strong novel risk factor for stroke: the practitioner-based nationwide J-HOP Nocturnal BP study”. Hypertens Res (2025). https://doi.org/10.1038/s41440-025-02480-w

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  • DOI: https://doi.org/10.1038/s41440-025-02480-w

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