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

Tatsuya Maruhashi; Yukako Tatsumi; Michihiro Satoh; Yusuke Kobayashi; Yukako Ogoyama; Atsushi Sakima; Hisatomi Arima; Takayoshi Ohkubo

doi:10.1038/s41440-024-02072-0

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

Hypertens Res. 2024 Dec 24. doi: 10.1038/s41440-024-02072-0. Online ahead of print.

Authors

Tatsuya Maruhashi^#¹, Yukako Tatsumi^#², Michihiro Satoh^{3

4}, Yusuke Kobayashi^{5

6}, Yukako Ogoyama⁷, Atsushi Sakima⁸, Hisatomi Arima⁹, Takayoshi Ohkubo¹⁰

Affiliations

¹ Department of Regenerative Medicine, Division of Radiation Medical Science, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan.
² Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.
³ 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.
⁷ Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi, 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.
¹⁰ Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan. tohkubo@med.teikyo-u.ac.jp.

^# Contributed equally.

PMID: 39719531
DOI: 10.1038/s41440-024-02072-0

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.

Keywords: Ambulatory blood pressure; Home blood pressure; Meta-analysis; Office blood pressure.