Research and Development of Information and Communication Technology-based Home Blood Pressure Monitoring from Morning to Nocturnal Hypertension

Asians have specific characteristics of <a title="Learn more about Hypertension" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/hypertension">hypertension</a> (HTN) and its relationship with <a title="Learn more about Cardiovascular disease&...

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Autores principales:	Kazuomi Kario, Naoko Tomitani, Yuri Matsumoto, Haruna Hamasaki, Yukie Okawara, Maiko Kondo, Ryoko Nozue, Hiromi Yamagata, Ayako Okura, Satoshi Hoshide
Formato:	article
Lenguaje:	EN
Publicado:	Ubiquity Press 2016
Materias:	home blood pressure hypertension Asians 24-hour blood pressure blood pressure variability Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/1b9e001503f14aa1a583b88bcb88f755
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id	oai:doaj.org-article:1b9e001503f14aa1a583b88bcb88f755
record_format	dspace
institution	DOAJ
collection	DOAJ
language	EN
topic	home blood pressure hypertension Asians 24-hour blood pressure blood pressure variability Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
spellingShingle	home blood pressure hypertension Asians 24-hour blood pressure blood pressure variability Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270 Kazuomi Kario Naoko Tomitani Yuri Matsumoto Haruna Hamasaki Yukie Okawara Maiko Kondo Ryoko Nozue Hiromi Yamagata Ayako Okura Satoshi Hoshide Research and Development of Information and Communication Technology-based Home Blood Pressure Monitoring from Morning to Nocturnal Hypertension
description	Asians have specific characteristics of <a title="Learn more about Hypertension" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/hypertension">hypertension</a> (HTN) and its relationship with <a title="Learn more about Cardiovascular disease" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/cardiovascular-disease">cardiovascular disease</a>. The morning surge in blood pressure (BP) in Asians is more extended, and the association slope between higher BP and the risk for cardiovascular events is steeper in this population than in whites. Thus, 24-hour BP control including at night and in the morning is especially important for Asian patients with HTN. There are 3 components of “perfect 24-hour BP control”: the 24-hour BP level, adequate dipping of nocturnal BP (dipper type), and adequate BP variability such as the morning BP surge. The morning BP-guided approach using home BP monitoring (HBPM) is the first step toward perfect 24-hour BP control. After controlling morning HTN, nocturnal HTN is the second target. We have been developing HBPM that can measure nocturnal BP. First, we developed a semiautomatic HBPM device with the function of automatic fixed-interval BP measurement during sleep. In the J-HOP (Japan Morning Surge Home Blood Pressure) study, the largest nationwide home BP cohort, we successfully measured nocturnal home BP using this device with data memory, 3 times during sleep (2, 3, and 4 am), and found that nocturnal home BP is significantly correlated with organ damage independently of office and morning BP values. The second advance was the development of trigger nocturnal BP (TNP) monitoring with an added trigger function that initiates BP measurements when oxygen desaturation falls below a variable threshold continuously monitored by <a title="Learn more about Pulse oximetry" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/pulse-oximetry">pulse oximetry</a>. TNP can detect the specific nocturnal BP surges triggered by hypoxic episodes in patients with sleep apnea syndrome. We also added the lowest heart rate-trigger function to TNP to detect the “basal nocturnal BP,” which is determined by the circulating volume and structural <a title="Learn more about Cardiovascular System" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/cardiovascular-system">cardiovascular system</a> without any increase in sympathetic tonus. This double TNP is a novel concept for evaluating the pathogenic <a title="Learn more about Antihypotensive agent" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/antihypotensive-agent">pressor</a> mechanism of nocturnal BP. These data are now collected using an information and communication technology (ICT)-based monitoring system. The BP variability includes different time-phase variability from the shortest beat-by-beat, positional, diurnal, day-by-day, visit-to-visit, seasonal, and the longest yearly changes. The synergistic resonance of each type of BP variability would produce great dynamic BP surges, which trigger cardiovascular events. Thus, in the future, the management of HTN based on the simultaneous assessment of the resonance of all of the BP variability phenotypes using a wearable “surge” BP monitoring device with an ICT-based data analysis system will contribute to the ultimate individualized medication for cardiovascular disease.
format	article
author	Kazuomi Kario Naoko Tomitani Yuri Matsumoto Haruna Hamasaki Yukie Okawara Maiko Kondo Ryoko Nozue Hiromi Yamagata Ayako Okura Satoshi Hoshide
author_facet	Kazuomi Kario Naoko Tomitani Yuri Matsumoto Haruna Hamasaki Yukie Okawara Maiko Kondo Ryoko Nozue Hiromi Yamagata Ayako Okura Satoshi Hoshide
author_sort	Kazuomi Kario
title	Research and Development of Information and Communication Technology-based Home Blood Pressure Monitoring from Morning to Nocturnal Hypertension
title_short	Research and Development of Information and Communication Technology-based Home Blood Pressure Monitoring from Morning to Nocturnal Hypertension
title_full	Research and Development of Information and Communication Technology-based Home Blood Pressure Monitoring from Morning to Nocturnal Hypertension
title_fullStr	Research and Development of Information and Communication Technology-based Home Blood Pressure Monitoring from Morning to Nocturnal Hypertension
title_full_unstemmed	Research and Development of Information and Communication Technology-based Home Blood Pressure Monitoring from Morning to Nocturnal Hypertension
title_sort	research and development of information and communication technology-based home blood pressure monitoring from morning to nocturnal hypertension
publisher	Ubiquity Press
publishDate	2016
url	https://doaj.org/article/1b9e001503f14aa1a583b88bcb88f755
work_keys_str_mv	AT kazuomikario researchanddevelopmentofinformationandcommunicationtechnologybasedhomebloodpressuremonitoringfrommorningtonocturnalhypertension AT naokotomitani researchanddevelopmentofinformationandcommunicationtechnologybasedhomebloodpressuremonitoringfrommorningtonocturnalhypertension AT yurimatsumoto researchanddevelopmentofinformationandcommunicationtechnologybasedhomebloodpressuremonitoringfrommorningtonocturnalhypertension AT harunahamasaki researchanddevelopmentofinformationandcommunicationtechnologybasedhomebloodpressuremonitoringfrommorningtonocturnalhypertension AT yukieokawara researchanddevelopmentofinformationandcommunicationtechnologybasedhomebloodpressuremonitoringfrommorningtonocturnalhypertension AT maikokondo researchanddevelopmentofinformationandcommunicationtechnologybasedhomebloodpressuremonitoringfrommorningtonocturnalhypertension AT ryokonozue researchanddevelopmentofinformationandcommunicationtechnologybasedhomebloodpressuremonitoringfrommorningtonocturnalhypertension AT hiromiyamagata researchanddevelopmentofinformationandcommunicationtechnologybasedhomebloodpressuremonitoringfrommorningtonocturnalhypertension AT ayakookura researchanddevelopmentofinformationandcommunicationtechnologybasedhomebloodpressuremonitoringfrommorningtonocturnalhypertension AT satoshihoshide researchanddevelopmentofinformationandcommunicationtechnologybasedhomebloodpressuremonitoringfrommorningtonocturnalhypertension
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spelling	oai:doaj.org-article:1b9e001503f14aa1a583b88bcb88f7552021-12-02T06:31:53ZResearch and Development of Information and Communication Technology-based Home Blood Pressure Monitoring from Morning to Nocturnal Hypertension2214-999610.1016/j.aogh.2016.02.004https://doaj.org/article/1b9e001503f14aa1a583b88bcb88f7552016-06-01T00:00:00Zhttps://annalsofglobalhealth.org/articles/744https://doaj.org/toc/2214-9996Asians have specific characteristics of <a title="Learn more about Hypertension" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/hypertension">hypertension</a> (HTN) and its relationship with <a title="Learn more about Cardiovascular disease" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/cardiovascular-disease">cardiovascular disease</a>. The morning surge in blood pressure (BP) in Asians is more extended, and the association slope between higher BP and the risk for cardiovascular events is steeper in this population than in whites. Thus, 24-hour BP control including at night and in the morning is especially important for Asian patients with HTN. There are 3 components of “perfect 24-hour BP control”: the 24-hour BP level, adequate dipping of nocturnal BP (dipper type), and adequate BP variability such as the morning BP surge. The morning BP-guided approach using home BP monitoring (HBPM) is the first step toward perfect 24-hour BP control. After controlling morning HTN, nocturnal HTN is the second target. We have been developing HBPM that can measure nocturnal BP. First, we developed a semiautomatic HBPM device with the function of automatic fixed-interval BP measurement during sleep. In the J-HOP (Japan Morning Surge Home Blood Pressure) study, the largest nationwide home BP cohort, we successfully measured nocturnal home BP using this device with data memory, 3 times during sleep (2, 3, and 4 am), and found that nocturnal home BP is significantly correlated with organ damage independently of office and morning BP values. The second advance was the development of trigger nocturnal BP (TNP) monitoring with an added trigger function that initiates BP measurements when oxygen desaturation falls below a variable threshold continuously monitored by <a title="Learn more about Pulse oximetry" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/pulse-oximetry">pulse oximetry</a>. TNP can detect the specific nocturnal BP surges triggered by hypoxic episodes in patients with sleep apnea syndrome. We also added the lowest heart rate-trigger function to TNP to detect the “basal nocturnal BP,” which is determined by the circulating volume and structural <a title="Learn more about Cardiovascular System" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/cardiovascular-system">cardiovascular system</a> without any increase in sympathetic tonus. This double TNP is a novel concept for evaluating the pathogenic <a title="Learn more about Antihypotensive agent" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/antihypotensive-agent">pressor</a> mechanism of nocturnal BP. These data are now collected using an information and communication technology (ICT)-based monitoring system. The BP variability includes different time-phase variability from the shortest beat-by-beat, positional, diurnal, day-by-day, visit-to-visit, seasonal, and the longest yearly changes. The synergistic resonance of each type of BP variability would produce great dynamic BP surges, which trigger cardiovascular events. Thus, in the future, the management of HTN based on the simultaneous assessment of the resonance of all of the BP variability phenotypes using a wearable “surge” BP monitoring device with an ICT-based data analysis system will contribute to the ultimate individualized medication for cardiovascular disease.Kazuomi KarioNaoko TomitaniYuri MatsumotoHaruna HamasakiYukie OkawaraMaiko KondoRyoko NozueHiromi YamagataAyako OkuraSatoshi HoshideUbiquity Pressarticlehome blood pressurehypertensionAsians24-hour blood pressureblood pressure variabilityInfectious and parasitic diseasesRC109-216Public aspects of medicineRA1-1270ENAnnals of Global Health, Vol 82, Iss 2, Pp 254-273 (2016)

Research and Development of Information and Communication Technology-based Home Blood Pressure Monitoring from Morning to Nocturnal Hypertension

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