Home BP a better measure of CVD risk than office BP, says study

In middle-aged adults, masked hypertension is associated with several markers of cardiovascular disease (CVD), which suggests that home blood pressure (BP) may be a better predictor of risk, even when the recordings are done with the same measurement device, according to a study.

Some randomly selected 5,057 participants aged 50‒64 years from the Swedish CardioPulmonary Biolmage Study (SCAPIS) were assessed with office and home BP using the semi-automatic Omron M10-IT oscillometric device. The authors performed further analyses, such as pulse wave velocity (PWV) and coronary artery calcium score (CACS).

Of the participants, 4,122 were not currently being treated with antihypertensive medications and were thus included in this analysis. Among the eligible participants, 2,634 (63.9 percent) had sustained normotension, while 172 (4.2 percent) had masked hypertension.

Those with masked vs sustained hypertension were more likely to be men (66.9 percent vs 46.2 percent; p<0.001), had higher mean PWV (9.3 vs 8.3 m/s; p<0.001) and odds ratio for CACS at least 100 (1.65, 95 percent confidence interval, 1.02‒2.68; p=0.040).

A post hoc analysis of masked hypertension and sustained normotension, matched for age, sex, and systolic office BP, revealed similar associations.

“Masked hypertension is associated with CVD,” the authors said. “However, previous large studies have not used the same device to measure office and home BP and adhered to current home BP measurement recommendations of the European Society of Hypertension.”