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J Hypertens. 2019 May;37(5):905-916. doi: 10.1097/HJH.0000000000001987.

Nocturnal blood pressure measured by home devices: evidence and perspective for clinical application.

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Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo.
Tohoku Institute for Management of Blood Pressure, Sendai.
Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine.
Jichi Medical University Center of Excellence, Cardiovascular Research and Development (JCARD), Tochigi.
Hypertension Cardiovascular Outcome Prevention and Evidence in Asia (HOPE Asia) Network, Tokyo, Japan.
Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Athens, Greece.
Department of Medicine and Surgery, University of Milano-Bicocca.
Istituto Auxologico Italiano, IRCCS, Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Milan, Italy.
Calhoun Cardiology Center, University of Connecticut School of Medicine, Farmington, Connecticut.
Department of Medicine, State University of New York Downstate Medical Center, Brooklyn, New York, USA.


: Studies using ambulatory blood pressure (BP) monitoring have shown that BP during night-time sleep is a stronger predictor of cardiovascular outcomes than daytime ambulatory or conventional office BP. However, night-time ambulatory BP recordings may interfere with sleep quality because of the device cuff inflation and frequency of measurements. Hence, there is an unmet need for obtaining high quality BP values during sleep. In the last two decades, technological development of home BP devices enabled automated BP measurements during night-time. Preliminary data suggest that nocturnal home BP measurements yield similar BP values and show good agreement in detecting nondippers when compared with ambulatory BP monitoring. Thus, nocturnal home BP measurements might be a reliable and practical alternative to ambulatory BP monitoring to evaluate BP during sleep. As the use of home BP devices is widespread, well accepted by users and has relatively low cost, it may prove to be more feasible and widely available for routine clinical assessment of nocturnal BP. At present, however, data on the prognostic relevance of nocturnal BP measured by home devices, the optimal measurement schedule, and other methodological issues are lacking and await further investigation. This article offers a systematic review of the current evidence on nocturnal home BP, highlights the remaining research questions, and provides preliminary recommendations for application of this novel approach in BP management.

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