Prediction of Stroke by Self-Measurement of Blood Pressure at Home Versus Casual Screening Blood Pressure Measurement in Relation to the Joint National Committee 7 Classification

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Abstract
Background and Purpose— To compare the predictive power of self-measured home blood pressure (HBP) and casual blood pressure (CBP) for stroke risk in relation to the Joint National Committee 7 (JNC-7) classification. Methods— HBP and CBP measurements were taken in 1702 subjects (≥40 years) without a history of stroke, who were followed up for an average of 11 years. Subjects were classified into 4 groups on the basis of either HBP or CBP, according to the JNC-7 criteria: group 1 (HBP Results— The stroke risk in groups 3b and 4b (defined by HBP and CBP) was 2 to 5× higher than that in group 1 with significant differences. The risk in groups 2a, 3a, and even 4a was not significantly different from that in group 1 by the CBP-based classification, but the risk in group 4a was significantly higher than that in group 1 by the HBP-based classification, which also showed a stepwise increase in risk from groups 2a to 4a. Conclusions— The JNC-7 classification had a stronger predictive power using HBP-based classification compared with CBP-based classification, suggesting the usefulness of HBP in the management of hypertension.