The association between home vs. ambulatory night-time blood pressure and end-organ damage in the general population

Objective: The aim of this study was to test the agreement between night-time home and night-time ambulatory blood pressure (BP) and to compare their associations with hypertensive end-organ damage for the first time in the general population. Methods: A population sample of 248 participants underwent measurements for night-time home BP (three measurements on two nights with a timer-equipped home device), night-time ambulatory BP, pulse wave velocity (PWV), carotid intima media thickness (IMT) and echocardiographic left ventricular mass index (LVMI). Results: No significant or systematic differences were observed between mean night-time ambulatory and home BPs (systolic/diastolic difference: 0.7 +/- 76/0.2 +/- 6.0 mmHg, P= 0.16/0.64). All night-time home and ambulatory BPs were positively correlated with PWV, IMT and LVMI (P<0.01 for all). No significant differences in Pearson's correlations between end-organ damage and night-time home or ambulatory BP were observed (P> 0.11 for all comparisons using Dunn and Clark's Z), except for a slightly stronger correlation between PWV and ambulatory SBP than for home SBP (r=0.57 vs. 0.50, P= 0.03). The adjusted R-2 of all multivariable-adjusted models for PWV, IMT or LVMI that included night-time home or ambulatory SBP/DBP were within 2/1%. Conclusion: Our study demonstrates that night-time home and ambulatory measurements produce similar BP values that have comparable associations with end-organ damage in the general population even when a clinically feasible measurement protocol is used for measuring night-time home BP. In the future, night-time home BP measurement may offer a feasible and easily accessible alternative to ambulatory monitoring for the measurement of night-time BP.