Prognosis of Isolated Systolic and Isolated Diastolic Hypertension as Assessed by Self-Measurement of Blood Pressure at Home

Open Access
Publisher Website
Google Scholar
Abstract
THE DIAGNOSIS of hypertension is usually based on blood pressure (BP%) criteria for both systolic and diastolic BP (SBP and DBP, respectively).1,2 However, some subjects fulfill only the SBP or only the DBP criteria. These subjects are categorized as having isolated systolic hypertension (ISH) or isolated diastolic hypertension (IDH). While the prognostic significance of ISH has been established by longitudinal intervention trials and meta-analysis,3-6 only 2 longitudinal studies investigated the prognostic significance of IDH.7,8 In these studies, the diagnosis of hypertension was based on casual or clinic measurements of BP. Casual BP measurement is known to have several limitations, such as poor reproducibility, the presence of a "white coat effect," observer bias. Recently, the use of self-measurement of BP at home (hereafter referred to as "home BP measurement"), which has been reported to have a better reproducibility9-11 and prognostic value than casual BP measurement,12 has been acknowledged. The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure1 and the 1999 World Health Organization-International Society of Hypertension Guidelines for the Management of Hypertension2 have also emphasized its usefulness. Since 1987, we have been conducting a prospective cohort study to investigate the relationship between home BP measurements and survival in the general population of Ohasama, Japan.12-15 The objective of this substudy was to clarify the prognostic significance of ISH and IDH, assessed using home BP measurements, in estimating the cardiovascular outcome for this general population.

This publication has 16 references indexed in Scilit: