Hypertension Research

Updated meta-analysis for antihypertensive treatment guided by home blood pressure compared to treatment based on office blood pressure: systematic review

Tatsuya Maruhashi ¹

Yukako Tatsumi ²

Michihiro Satoh ^{3, 4}

Yusuke Kobayashi ^{5, 6}

Yukako Ogoyama ⁷

Atsushi Sakima ⁸

Hisatomi Arima ⁹

Takayoshi Ohkubo ²

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Department of Regenerative Medicine, Division of Radiation Medical Science, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan |

Department of Hygiene and Public health, Teikyo University School of Medicine, Tokyo, Japan |

Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan |

⁴

Department of Pharmacy, Tohoku Medical and Pharmaceutical University Hospital, Sendai, Japan |

⁵

YCU Co-Creation Innovation Center, Yokohama City University, Yokohama, Japan |

⁶

Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan |

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Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan |

⁸

Health Administration Center, University of the Ryukyus, Okinawa, Japan |

⁹

Department of Preventive Medicine & Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan

Publication type: Journal Article

Publication date: 2024-12-24

Springer Nature

Journal: Hypertension Research

scimago Q2

SJR: 0.934

CiteScore: 7.4

Impact factor: 4.3

ISSN: 09169636, 13484214

DOI: 10.1038/s41440-024-02072-0

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Abstract

Home blood pressure (BP) measurement is widely used, and home BP plays a central role in hypertension management in clinical practice in Japan. We updated the systematic review to determine whether home BP-based antihypertensive treatment is superior to office BP-based treatment in improving clinical outcomes, including BP levels, in adult patients with essential hypertension. A literature search identified 14 randomized controlled trials (RCTs). The results of meta-analysis revealed that home BP-based antihypertensive treatment was significantly associated with greater reductions in ambulatory systolic BP by 2.73 mmHg (95% confidence interval [CI], –5.23 to –2.22 mmHg; p = 0.03) and ambulatory diastolic BP by 1.61 mmHg (95% CI, –3.21 to –0.01 mmHg; p = 0.05) compared to office BP-based treatment. No RCTs evaluating cardiovascular outcomes other than ambulatory BP reduction were identified. Consistent with the previous review, this updated meta-analysis revealed home BP-based antihypertensive treatment is strongly recommended over office BP-based treatment for BP control in patients with essential hypertension.