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European Heart Journal Advance Access originally published online on May 25, 2005
European Heart Journal 2005 26(19):2026-2031; doi:10.1093/eurheartj/ehi330
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© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Use of 2003 European Society of Hypertension–European Society of Cardiology guidelines for predicting stroke using self-measured blood pressure at home: the Ohasama study

Kei Asayama1,4, Takayoshi Ohkubo2,4, Masahiro Kikuya2, Hirohito Metoki1, Taku Obara1, Haruhisa Hoshi5, Junichiro Hashimoto2,4, Kazuhito Totsune1,4, Hiroshi Satoh3,4 and Yutaka Imai1,2,4,*

1Department of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Sciences and Medicine, 1-1 Seiryo-cho, Aoba-ku, Sendai 980-8574, Japan
2Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences and Medicine, 1-1 Seiryo-cho, Aoba-ku, Sendai 980-8574, Japan
3Department of Environmental Health Sciences, Tohoku University Graduate School of Pharmaceutical Sciences and Medicine, 1-1 Seiryo-cho, Aoba-ku, Sendai 980-8574, Japan
4Comprehensive Research and Education Center for Planning of Drug Development and Clinical Evaluation, Tohoku University 21st Century COE Program, Sendai, Japan
5Ohasama Hospital, Iwate, Japan

Received 4 December 2004; revised 16 March 2005; accepted 22 April 2005; online publish-ahead-of-print 25 May 2005.

* Corresponding author. Tel: +81 22 717 7770; fax: +81 22 717 7776. E-mail address: rinsyo{at}bureau.tohoku.ac.jp

Aims To evaluate the predictive power of the risk stratification system proposed in the 2003 European Society of Hypertension–European Society of Cardiology (2003 ESH–ESC) guidelines and to compare self-measured blood pressure at home (HBP) with casual-screening blood pressure (CBP) for prediction of first stroke among a general Japanese population.

Methods and results HBP and CBP were measured in 1702 subjects (≥40 years) who had no history of stroke and who were followed for an average of 11 years. The subjects were assigned to one of five groups with differential risk stratification according to the 2003 ESH–ESC criteria: average risk, low added risk, moderate added risk, high added risk, and very high added risk. Even in the low risk group a significantly high risk for stroke was observed, and there was a linear step up of stroke risk based on HBP, as well as on CBP. On the basis of HBP classification, a higher stroke incidence was observed in the high and very high groups compared with CBP classification.

Conclusion The risk stratification system proposed in the 2003 ESH–ESC guidelines is valid for the prediction of stroke in this Japanese study population, and has a stronger predictive power when based on HBP than on CBP. The results indicate the usefulness of HBP for the prediction of stroke risk in individuals.

Key Words: Blood pressure • Home measurement • Screening measurement • Stroke • ESH-ESC guidelines • Risk stratification


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K. Asayama, T. Ohkubo, M. Kikuya, T. Obara, H. Metoki, R. Inoue, A. Hara, T. Hirose, H. Hoshi, J. Hashimoto, et al.
Prediction of Stroke by Home "Morning" Versus "Evening" Blood Pressure Values: The Ohasama Study
Hypertension, October 1, 2006; 48(4): 737 - 743.
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