Key result
Thai hypertensive patients linked to ~4-fold higher odds of non-dipping nocturnal BP vs Japanese peers.
Why the study?
Blood pressure profiles and cardiovascular disease risk factors might differ among different Asian populations due to diverse cultures, foods, and environments, but intra-Asian differences remain unclear.
Are there differences in 24-h ambulatory blood pressure profiles between Japanese and Thai patients with hypertension or suspected hypertension?
Observational (n=1,855)
Yes
Are there differences in 24-h ambulatory blood pressure profiles between Japanese and Thai patients with hypertension or suspected hypertension?
Significant differences exist in 24-hour ambulatory blood pressure profiles between Japanese and Thai hypertensive patients despite similar office blood pressures, highlighting the need for population-specific ABPM evaluation.
Thai patients show more non-dipping/riser patterns than Japanese despite similar office BP; leaves open whether ethnicity-specific ABPM thresholds improve risk stratification.
Ethnic differences in the profiles of hypertension and cardiovascular risk have been reported between Asians and Westerners. However, blood pressure (BP) profiles and the risk factors for cardiovascular disease might differ even among different Asian populations because of the diversity of cultures, foods, and environments. We retrospectively examined differences in 24-h BP profiles between 1051 Japanese (mean age, 62.5 ± 12.4 years; medicated hypertension, 75.7%) and 804 Thai (mean age, 56.9 ± 18.5 years; medicated hypertension, 65.6%) by using the Japanese and Thai ambulatory BP monitoring (ABPM) databases, in order to check the BP control status in treated hypertensives and to inform the clinical diagnosis of hypertension. The two populations had similar office systolic BP (SBP) (142.7 ± 20.0 vs 142.3 ± 20.6 mm Hg, p = .679). However, the Japanese population had higher 24-hr average and daytime SBP, and the Thai population had higher nighttime SBP even after adjusting for cardiovascular risk factors (all p < .05). Greater morning BP surge was observed in Japanese (31.2 vs 22.8 mm Hg, p < .001). Regarding nocturnal BP dipping status, the prevalence of riser status (higher nighttime than daytime SBP) was higher in the Thai population (30.5% vs 10.9%). These findings suggest that a substantial difference in 24-hr BP profiles exists between even neighboring countries in Asia.
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Tomitani et al. (2020) conducted an observational in Hypertension or suspected hypertension (n=1,855). Thai population vs. Japanese population was evaluated on Prevalence of non-dipper or riser nocturnal blood pressure pattern (OR 4.41, 95% CI 3.38-5.75, p=<0.001). Thai patients with hypertension had a significantly higher prevalence of non-dipper or riser nocturnal blood pressure patterns compared to Japanese patients (73.9% vs 46.7%, OR 4.41) despite similar office blood pressure.
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