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Optimizing the role of home blood pressure monitoring: The Asia BP@Home study

12 Apr 2018
Hypertension affects around 1.4 billion people worldwide, and is particularly burdensome in Asian populations. To address this growing health issue, a group of cardiovascular (CV) disease experts have established the HOPE Asia Network and initiated a study to further our understanding of hypertension in Asian patients.

The Asia BP@Home study is utilizing home blood pressure monitoring (HBPM) to investigate how well blood pressure (BP) measurements taken in a clinic and at home correlate amongst 1,600 patients with hypertension. The study is also examining whether BP levels differ across 12 countries and regions in Asia. Recruitment was completed at the end of 2017 with the first results expected in mid-2018.

The basis of the study comes from evidence that BP variability can have significant clinical implications for CV risk and is more common in Asian versus Western populations. As noted by Professor Kazuomi Kario, lead investigator of the Asia BP@Home study:

“We believe uncontrolled morning hypertension is a particularly relevant risk factor for stroke and heart failure in Asia.”

Measuring BP at home, when surges may be greatest, has the potential to influence treatment choice, outcomes and the subsequent risk of mortality for Asian patients with hypertension. For example, a recent study in Japan found that patients with drug-resistant hypertension experience significant surges in BP in the morning and in the evening. HBPM readings are also more strongly predictive of patient mortality than measurements taken in the clinic. Therefore, data from HBPM may facilitate more consistent BP control, especially during the morning when the risk of a CV event is highest. Professor Kario highlighted that:

“A focus on effectively managing patients’ BP at home in the morning could result in a significant reduction in CV events throughout Asia.”

There is currently limited data on hypertension subtypes in Asian patients. For example, patients may be hypertensive in the clinic, but normotensive at home (‘whitecoat effect’), or vice versa (‘masked hypertension’). Data from the Asia BP@Home study are expected to provide such additional information and deliver insight on the benefits of using HBPM to manage patients with hypertension across Asia.

Many physicians in Asia are also beginning to appreciate that clinic-based measurements only provide a snapshot of BP control. HBPM is increasingly being recognized as delivering a fuller picture and as a valuable strategy for optimizing the diagnosis and management of hypertension.

Data generated from the Asia BP@Home study, along with the Network’s efforts to publish Asia-specific reviews and consensus statements, will be used to improve patient BP control and reduce CV events throughout Asia. By highlighting the region-specific challenges of managing hypertension, it is anticipated that CV disease-related research will be stimulated across Asia, ultimately improving outcomes for Asian patients.

Reference: Kario K, et al. J Clin Hypertens 2018;20:33–38
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