Evidence map›Paper›PMID 31006331›Full record

ArticleHypertension (Dallas, Tex. : 1979)2019

Nighttime Blood Pressure Measured by Home Blood Pressure Monitoring as an Independent Predictor of Cardiovascular Events in General Practice.

Kazuomi Kario, Hiroshi Kanegae, Naoko Tomitani, Yukie Okawara, Takeshi Fujiwara, Yuichiro Yano, Satoshi Hoshide

Registry-linked trialOpen access · hybridAbstract readMulticenter Study
In one paragraph

Article in Hypertension (Dallas, Tex. : 1979), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06380491 (Impact of Melatonin Treatment on Blood Pressure Circadian Rhythm, Sleep and Metabolic Variables.), which is not on this map. Cited by 93 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
93citing papers in PubMed, 4 pooled it
15.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06380491 phase4recruitingnot on this mapstarted 2023, after this paper: background citation

Impact of Melatonin Treatment on Blood Pressure Circadian Rhythm, Sleep and Metabolic Variables.

TypeinterventionalSponsorInstituto Nacional de Ciencias Medicas y Nutricion Salvador ZubiranRan2023 to 2028Enrolled50ConditionsObstructive Sleep Apnea of AdultArmsMelatonin 3 MG Oral Tablet
3 · Its place in the literature

Who cites it

93 citing papers in PubMed, 4 syntheses or guidelines pooled it, 159 citations in OpenAlex.

  1. Guideline
  2. Chronotherapy for Hypertension: A Meta-Analysis and Systematic Review of RCTs.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2025
    Pooled it
  3. Guideline
  4. Pooled it
  5. Trial
  6. Trial
  7. Trial
  8. Trial
  9. Trial
  10. Trial
  11. Article
  12. Beyond office blood pressure: J-SAMIT and the emerging era of implementation hypertension.Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Article
  13. Article
  14. Review
  15. Article
  16. Article
  17. The Japanese Society of Hypertension Guidelines for the management of elevated blood pressure and hypertension 2025 (JSH2025).Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Article
  18. Digital hypertension - what we need for the high-quality management of hypertension in the new era.Hypertension research : official journal of the Japanese Society of Hypertension · 2025
    Review
  19. Review
  20. Article

33 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Kazuomi KarioFrom the Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine (JMU), Tochigi, Japan (K.K., H.K., N.T., T.F., S.H.).
Hiroshi KanegaeFrom the Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine (JMU), Tochigi, Japan (K.K., H.K., N.T., T.F., S.H.).
Naoko TomitaniFrom the Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine (JMU), Tochigi, Japan (K.K., H.K., N.T., T.F., S.H.).
Yukie OkawaraJMU Center of Global Home and Ambulatory BP Analysis (GAP), Tochigi, Japan (Y.O.).
Takeshi FujiwaraFrom the Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine (JMU), Tochigi, Japan (K.K., H.K., N.T., T.F., S.H.).
Yuichiro YanoJMU Center of Excellence, Community Medicine Cardiovascular Research and Development (JCARD), Tochigi, Japan (K.K., N.T., T.F., Y.Y., S.H.).
Satoshi HoshideFrom the Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine (JMU), Tochigi, Japan (K.K., H.K., N.T., T.F., S.H.).
Jichi Medical University · JPGenki Plaza Medical Center for Health Care · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

We developed an innovative automated home blood pressure (BP) monitoring method that measures BP while asleep repeatedly over several days. Our aim was to assess the predictive ability of nighttime BP obtained using the home BP device for incident cardiovascular disease (CVD) in general practice patients. We used data from the nationwide practice-based J-HOP (Japan Morning Surge-Home Blood Pressure) Nocturnal BP Study, which recruited 2545 Japanese with a history of or risk factors for CVD (mean age 63 years; antihypertensive medication use 83%). The associations between nighttime home BPs (measured at 2:00, 3:00, and 4:00 am using validated, automatic, and oscillometric home BP devices) and incident CVD, including coronary disease and stroke events, were assessed with Cox proportional hazards models. The mean±SD office, morning home, and nighttime home systolic BP (SBP)/diastolic BP were 140±15/82±10, 137±15/79±10, and 121±15/70±9 mm Hg, respectively. During a follow-up of 7.1±3.8 years (18,116 person-years), 152 CVD events occurred. A 10-mm Hg increase of nighttime home SBP was associated with an increased risk of CVD events (hazard ratios [95% CIs]: 1.201 [1.046-1.378]), after adjustments for covariates including office and morning home SBPs. The model fit assessed by the change in Goodness-of-Fit was improved when we added nighttime home SBP into the base models including office and morning home SBPs (Δ6.838 [5.6%]; P=0.009). This is among the first and largest nationwide practice-based study demonstrating that nighttime SBP obtained using a home device is a predictor of incident CVD events, independent of in-office and morning in-home SBP measurement. Clinical Trial Registration- URL: http://www.umin.ac.jp/icdr/index.html . Unique identifier: UMIN000000894.

Indexed as

Circadian RhythmBlood PressureBlood Pressure Monitoring, AmbulatoryCardiovascular DiseasesFemaleFollow-Up StudiesGeneral PracticeHumansIncidenceJapanMaleMiddle AgedPrognosisSystoleTime Factorsblood pressurecardiovascular diseasehypertensionstroke

Identifiers

PMID31006331
PMCPMC6510323
OpenAlexW2939115855

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.