Hypertension (Dallas, Tex. : 1979) · 2026
IoT-Based Home Blood Pressure Time in Target Range and Brain Lesions on MRI.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Hisamatsu Takashi, Fukuda Mari, Kinuta Minako, Kojima Katsuhide, Taniguchi Kaori, Nakahata Noriko, Kanda Hideyuki
Аннотация
BACKGROUND: Time in target range (TTR) reflects the proportion of time that blood pressure (BP) stays within guideline-recommended levels. However, the distribution of home BP TTR and its association with subclinical cerebrovascular disease in community-based populations remain unclear.
METHODS: We investigated annual and seasonal TTR of Internet of Things-based home BP and its association with brain lesions on magnetic resonance imaging in a community-based cohort. Home BP was measured twice daily (morning and evening). Weekly mean BP was calculated from ≥3 valid daily readings, and TTR was defined in those with ≥2 valid weeks/season as the percentage of weeks meeting guideline-based targets (systolic and diastolic BP <135 and <85 mm Hg, respectively, for participants not receiving antihypertensive medication; <125 and <75 mm Hg, respectively, for those receiving medication). Brain lesions included ≥1 magnetic resonance imaging-detected lacunar infarct, white matter hyperintensities, cerebral microbleeds, or intracranial artery stenosis.
RESULTS: Among 306 participants (mean age, 56 years; 57% women), median annual TTR was 100% (interquartile range, 92.6%-100%) in participants not receiving antihypertensive medication and 1.9% (0%-19.2%) in those receiving medication. TTR tended to be lower in winter than in summer. In Poisson regression with robust variance, adjusted for demographic, lifestyle, and clinical factors, higher TTR was associated with a lower prevalence of brain lesions (prevalence ratio per 10% higher, 0.85 [95% CI, 0.79-0.91]). The association was stronger among participants not receiving antihypertensive medication (interaction P=0.047), with no heterogeneity across seasons (interaction P=0.958).
CONCLUSIONS: Home BP TTR may help characterize longitudinal BP control and provide complementary information regarding cerebrovascular health.
METHODS: We investigated annual and seasonal TTR of Internet of Things-based home BP and its association with brain lesions on magnetic resonance imaging in a community-based cohort. Home BP was measured twice daily (morning and evening). Weekly mean BP was calculated from ≥3 valid daily readings, and TTR was defined in those with ≥2 valid weeks/season as the percentage of weeks meeting guideline-based targets (systolic and diastolic BP <135 and <85 mm Hg, respectively, for participants not receiving antihypertensive medication; <125 and <75 mm Hg, respectively, for those receiving medication). Brain lesions included ≥1 magnetic resonance imaging-detected lacunar infarct, white matter hyperintensities, cerebral microbleeds, or intracranial artery stenosis.
RESULTS: Among 306 participants (mean age, 56 years; 57% women), median annual TTR was 100% (interquartile range, 92.6%-100%) in participants not receiving antihypertensive medication and 1.9% (0%-19.2%) in those receiving medication. TTR tended to be lower in winter than in summer. In Poisson regression with robust variance, adjusted for demographic, lifestyle, and clinical factors, higher TTR was associated with a lower prevalence of brain lesions (prevalence ratio per 10% higher, 0.85 [95% CI, 0.79-0.91]). The association was stronger among participants not receiving antihypertensive medication (interaction P=0.047), with no heterogeneity across seasons (interaction P=0.958).
CONCLUSIONS: Home BP TTR may help characterize longitudinal BP control and provide complementary information regarding cerebrovascular health.