Key result
Higher morning home systolic blood pressure was associated with an increased risk of winter-onset cardiovascular events (HR 1.22; 95% CI 1.06-1.42 per 10 mm Hg increase).
Why the study?
Cardiovascular disease incidence increases during winter, but the risk that elevated home BP poses for CVD events across each of four seasons remains unclear.
Is morning home blood pressure associated with the onset of cardiovascular events during winter in patients with cardiovascular risks?
Cohort (n=4,258)
Yes
Is morning home blood pressure associated with the onset of cardiovascular events during winter in patients with cardiovascular risks?
Hazard Ratio: 1.22 (95% CI 1.06–1.42)
Morning home blood pressure is a superior predictor of winter-onset cardiovascular events compared to evening home blood pressure, highlighting the prognostic value of morning measurements for seasonal risk assessment.
May guide seasonal CV risk assessment via morning home SBP; extends observational data but leaves causal effects open.
BACKGROUND: The incidence of cardiovascular disease (CVD) increases during winter. The risk that elevated home blood pressure (BP) poses for CVD events that occur in each of 4 seasons is unclear. We conducted a post hoc analysis using the dataset from a nationwide cohort, the Japan Morning Surge-Home Blood Pressure (J-HOP) study, to assess the association between home BP and winter-onset CVD events. METHODS: J-HOP participants who had cardiovascular risks conducted morning and evening home BP measurements for a 14-day period and were followed-up for the occurrence of CVD events. RESULTS: We analyzed 4,258 participants (mean age 64.9 years; 47% male; 92% hypertensives) who were followed-up for an average of 6.2 ± 3.8 years (26,295 person-years). We divided the total of 269 CVD events (10.2/1,000 person-years) by the season of onset as follows: 82 in the winter and 187 in the other seasons (spring, summer, and autumn). In the Cox models adjusted for covariates and the season when home BPs were measured at baseline, morning home systolic BP (SBP) was associated with both winter-onset and other season-onset CVD events: hazard ratio (HR) for winter 1.22, 95% confidence interval (CI) 1.06-1.42 per 10 mm Hg; HR for other seasons 1.11, 95% CI 1.00-1.23. Evening home SBP was associated with the other season-onset CVD events (HR 1.20, 95% CI 1.08-1.33 per 10 mm Hg), but not with the winter-onset CVD events. CONCLUSIONS: Our findings indicate that compared with evening home BP, morning home BP might be a superior predictor of winter-onset CVD events.
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Narita et al. (2021) conducted a cohort in Cardiovascular risks (n=4,258). Morning home systolic blood pressure vs. Evening home systolic blood pressure was evaluated on Winter-onset cardiovascular events (HR 1.22, 95% CI 1.06-1.42). Higher morning home systolic blood pressure was associated with an increased risk of winter-onset cardiovascular events (HR 1.22; 95% CI 1.06-1.42 per 10 mm Hg increase).
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