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1. Requirements for design and function of blood pressure measuring devices used for the management of hypertension: Consensus Statement by the European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability and STRIDE BP

Author

Stergiou, G, Parati, G, Kollias, A, Schutte, A, Asayama, K, Asmar, R, Bilo, G, De La Sierra, A, Dolan, E, Filipovsky, J, Head, G, Kario, K, Kyriakoulis, K, Mancia, G, Manios, E, Menti, A, Mcmanus, R, Mihailidou, A, Muntner, P, Niiranen, T, Ohkubo, T, Omboni, S, Protogerou, A, Saladini, F, Sharman, J, Shennan, A, Shimbo, D, Topouchian, J, Wang, J, O'Brien, E, Palatini, P, Stergiou G. S., Parati G., Kollias A., Schutte A. E., Asayama K., Asmar R., Bilo G., De La Sierra A., Dolan E., Filipovsky J., Head G., Kario K., Kyriakoulis K. G., Mancia G., Manios E., Menti A., McManus R. J., Mihailidou A. S., Muntner P., Niiranen T., Ohkubo T., Omboni S., Protogerou A., Saladini F., Sharman J., Shennan A., Shimbo D., Topouchian J., Wang J., O'Brien E., Palatini P., Stergiou, G, Parati, G, Kollias, A, Schutte, A, Asayama, K, Asmar, R, Bilo, G, De La Sierra, A, Dolan, E, Filipovsky, J, Head, G, Kario, K, Kyriakoulis, K, Mancia, G, Manios, E, Menti, A, Mcmanus, R, Mihailidou, A, Muntner, P, Niiranen, T, Ohkubo, T, Omboni, S, Protogerou, A, Saladini, F, Sharman, J, Shennan, A, Shimbo, D, Topouchian, J, Wang, J, O'Brien, E, Palatini, P, Stergiou G. S., Parati G., Kollias A., Schutte A. E., Asayama K., Asmar R., Bilo G., De La Sierra A., Dolan E., Filipovsky J., Head G., Kario K., Kyriakoulis K. G., Mancia G., Manios E., Menti A., McManus R. J., Mihailidou A. S., Muntner P., Niiranen T., Ohkubo T., Omboni S., Protogerou A., Saladini F., Sharman J., Shennan A., Shimbo D., Topouchian J., Wang J., O'Brien E., and Palatini P.

Abstract

Objective:To develop scientific consensus recommendations for the optimal design and functions of different types of blood pressure (BP) measuring devices used in clinical practice for the detection, management, and long-term follow-up of hypertension.Methods:A scientific consensus meeting was performed by the European Society of Hypertension (ESH) Working Group on BP Monitoring and Cardiovascular Variability and STRIDE BP (Science and Technology for Regional Innovation and Development in Europe) during the 2022 Scientific Meeting of the ESH in Athens, Greece. Manufacturers were also invited to provide their feedback on BP device design and development. Thirty-one international experts in clinical hypertension and BP monitoring contributed to the development of consensus recommendations on the optimal design of BP devices.Statement:International consensus was reached on the requirements for the design and features of five types of BP monitors, including office (or clinic) BP monitors, ambulatory BP monitors, home BP monitors, home BP telemonitors, and kiosk BP monitors for public spaces. For each device type "essential" requirements (must have), and "optional" ones (may have) are presented, as well as additional comments on the optimal device design and features.Conclusions:These consensus recommendations aim at providing manufacturers of BP devices with the requirements that are considered mandatory, or optional, by clinical experts involved in the detection and management of hypertension. They are also directed to administrative healthcare personnel involved in the provision and purchase of BP devices so that they can recommend the most appropriate ones.

Published
2023

2. Blood pressure variability: methodological aspects, clinical relevance and practical indications for management - a European Society of Hypertension position paper ∗

Author

Parati, G, Bilo, G, Kollias, A, Pengo, M, Ochoa, J, Castiglioni, P, Stergiou, G, Mancia, G, Asayama, K, Asmar, R, Avolio, A, Caiani, E, De La Sierra, A, Dolan, E, Grillo, A, Guzik, P, Hoshide, S, Head, G, Imai, Y, Juhanoja, E, Kahan, T, Kario, K, Kotsis, V, Kreutz, R, Kyriakoulis, K, Li, Y, Manios, E, Mihailidou, A, Modesti, P, Omboni, S, Palatini, P, Persu, A, Protogerou, A, Saladini, F, Salvi, P, Sarafidis, P, Torlasco, C, Veglio, F, Vlachopoulos, C, Zhang, Y, Parati G., Bilo G., Kollias A., Pengo M., Ochoa J. E., Castiglioni P., Stergiou G. S., Mancia G., Asayama K., Asmar R., Avolio A., Caiani E. G., De La Sierra A., Dolan E., Grillo A., Guzik P., Hoshide S., Head G. A., Imai Y., Juhanoja E., Kahan T., Kario K., Kotsis V., Kreutz R., Kyriakoulis K. G., Li Y., Manios E., Mihailidou A. S., Modesti P. A., Omboni S., Palatini P., Persu A., Protogerou A. D., Saladini F., Salvi P., Sarafidis P., Torlasco C., Veglio F., Vlachopoulos C., Zhang Y., Parati, G, Bilo, G, Kollias, A, Pengo, M, Ochoa, J, Castiglioni, P, Stergiou, G, Mancia, G, Asayama, K, Asmar, R, Avolio, A, Caiani, E, De La Sierra, A, Dolan, E, Grillo, A, Guzik, P, Hoshide, S, Head, G, Imai, Y, Juhanoja, E, Kahan, T, Kario, K, Kotsis, V, Kreutz, R, Kyriakoulis, K, Li, Y, Manios, E, Mihailidou, A, Modesti, P, Omboni, S, Palatini, P, Persu, A, Protogerou, A, Saladini, F, Salvi, P, Sarafidis, P, Torlasco, C, Veglio, F, Vlachopoulos, C, Zhang, Y, Parati G., Bilo G., Kollias A., Pengo M., Ochoa J. E., Castiglioni P., Stergiou G. S., Mancia G., Asayama K., Asmar R., Avolio A., Caiani E. G., De La Sierra A., Dolan E., Grillo A., Guzik P., Hoshide S., Head G. A., Imai Y., Juhanoja E., Kahan T., Kario K., Kotsis V., Kreutz R., Kyriakoulis K. G., Li Y., Manios E., Mihailidou A. S., Modesti P. A., Omboni S., Palatini P., Persu A., Protogerou A. D., Saladini F., Salvi P., Sarafidis P., Torlasco C., Veglio F., Vlachopoulos C., and Zhang Y.

Abstract

Blood pressure is not a static parameter, but rather undergoes continuous fluctuations over time, as a result of the interaction between environmental and behavioural factors on one side and intrinsic cardiovascular regulatory mechanisms on the other side. Increased blood pressure variability (BPV) may indicate an impaired cardiovascular regulation and may represent a cardiovascular risk factor itself, having been associated with increased all-cause and cardiovascular mortality, stroke, coronary artery disease, heart failure, end-stage renal disease, and dementia incidence. Nonetheless, BPV was considered only a research issue in previous hypertension management guidelines, because the available evidence on its clinical relevance presents several gaps and is based on heterogeneous studies with limited standardization of methods for BPV assessment.The aim of this position paper, with contributions from members of the European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability and from a number of international experts, is to summarize the available evidence in the field of BPV assessment methodology and clinical applications and to provide practical indications on how to measure and interpret BPV in research and clinical settings based on currently available data. Pending issues and clinical and methodological recommendations supported by available evidence are also reported. The information provided by this paper should contribute to a better standardization of future studies on BPV, but should also provide clinicians with some indications on how BPV can be managed based on currently available data.

Published
2023

3. NMR Study of MnSi under Pressure

Author

Thessieu, C., Ishida, K., Kitaoka, Y., Asayama, K., and Lapertot, G.

Subjects
Condensed Matter - Strongly Correlated Electrons
Abstract

The magnetic phase diagram $T_c(P)$ of the weak itinerant helimagnetic compound MnSi is reviewed upon a Nuclear Magnetic Resonance (NMR) experiment. We present a systematic study on the evolution of the NMR spin echo signal at $T=1.4$ K of the non-magnetic silicone sites, $^{29}$Si, up to 17.8 kbar. The pressure effect is interpreted as a weak variation of the local electronic spin polarization and the coexistence of magnetic and non magnetic Mn atoms under pressure. From the volume dependence of $f_0$ ($P$), we show notably that a local magnetic order remains above the critical pressure of $P_c=14.8$ kbar., Comment: 9 pages, 2 figures. To be published in the Review of High Pressure Science and Technology

Published
1998

4. Pressure Effect on the Spin Fluctuations in YMn$_2$ --Mn NQR Study--

Author

Nishikido, K., Thessieu, C., Zheng, G-q., Kitaoka, Y., Asayama, K., and Hauser, R.

Subjects
Condensed Matter - Strongly Correlated Electrons
Abstract

We report the NQR study on the pressure-induced paramagnetic state in the antiferromagnetic (AF) intermetallic compound YMn$_2$ with the N\'eel temperature T_N=100 K at ambient pressure. From the $T$ variation of the nuclear spin-lattice relaxation rate, $^{55}(1/T_1)$ of $^{55}$Mn above the critical pressure of 4 kbar, the spin fluctuation feature is found to change below a temperature $T_{sf}$. At higher temperature than $T_{sf}$, the nuclear relaxation behavior is well described in terms of the self-consistent renomalized (SCR) spin fluctuation theory for nearly AF metals, whereas below $T_{sf}$ a deviation is significant and $1/T_1T$ exhibits a weak $T$ variation. It is pointed out that $T_{sf}$ coincides with the temperature below which a $T^{2}$ law in electrical resistivity is valid as expected for a Fermi liquid ground state. We proposed that these features are understood from the standpoint that the development of AF spin fluctuation remains in short-range associated with the singlet formation among Mn spins in each tetrahedron as suggested by the inelastic neutron experiments on $Y_{1-x}Sc_xMn_2$., Comment: 8 pages, 3 figures

Published
1998

11. Cuffless blood pressure measuring devices: review and statement by the European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability

Author

Stergiou, GS, Mukkamala, R, Avolio, A, Kyriakoulis, KG, Mieke, S, Murray, A, Parati, G, Schutte, AE, Sharman, JE, Asmar, R, De La Sierra, A, Asayama, K, McManus, RJ, Head, G, Kario, K, Kollias, A, Myers, M, Niiranen, T, Ohkubo, T, Wang, J, Wuerzner, G, O'Brien, E, Kreutz, R, Palatini, P, and Variability, European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular

Subjects
Physiology, Calibration, Hypertension, Internal Medicine, Humans, Blood Pressure, Blood Pressure Determination, Sphygmomanometers, Cardiology and Cardiovascular Medicine
Abstract

Background: Many cuffless blood pressure (BP) measuring devices are currently on the market claiming that they provide accurate BP measurements. These technologies have considerable potential to improve the awareness, treatment, and management of hypertension. However, recent guidelines by the European Society of Hypertension do not recommend cuffless devices for the diagnosis and management of hypertension. Objective: This statement by the European Society of Hypertension Working Group on BP Monitoring and Cardiovascular Variability presents the types of cuffless BP technologies, issues in their validation, and recommendations for clinical practice. Statements: Cuffless BP monitors constitute a wide and heterogeneous group of novel technologies and devices with different intended uses. Cuffless BP devices have specific accuracy issues, which render the established validation protocols for cuff BP devices inadequate for their validation. In 2014, the Institute of Electrical and Electronics Engineers published a standard for the validation of cuffless BP devices, and the International Organization for Standardization is currently developing another standard. The validation of cuffless devices should address issues related to the need of individual cuff calibration, the stability of measurements post calibration, the ability to track BP changes, and the implementation of machine learning technology. Clinical field investigations may also be considered and issues regarding the clinical implementation of cuffless BP readings should be investigated. Conclusion: Cuffless BP devices have considerable potential for changing the diagnosis and management of hypertension. However, fundamental questions regarding their accuracy, performance, and implementation need to be carefully addressed before they can be recommended for clinical use.

Published
2022

12. Seasonal variation in blood pressure: Evidence, consensus and recommendations for clinical practice. Consensus statement by the European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability

Author

Stergiou, G, Palatini, P, Modesti, P, Asayama, K, Asmar, R, Bilo, G, De La Sierra, A, Dolan, E, Head, G, Kario, K, Kollias, A, Manios, E, Mihailidou, A, Myers, M, Niiranen, T, Ohkubo, T, Protogerou, A, Wang, J, O'Brien, E, Parati, G, Stergiou G. S., Palatini P., Modesti P. A., Asayama K., Asmar R., Bilo G., De La Sierra A., Dolan E., Head G., Kario K., Kollias A., Manios E., Mihailidou A. S., Myers M., Niiranen T., Ohkubo T., Protogerou A., Wang J., O'Brien E., Parati G., Stergiou, G, Palatini, P, Modesti, P, Asayama, K, Asmar, R, Bilo, G, De La Sierra, A, Dolan, E, Head, G, Kario, K, Kollias, A, Manios, E, Mihailidou, A, Myers, M, Niiranen, T, Ohkubo, T, Protogerou, A, Wang, J, O'Brien, E, Parati, G, Stergiou G. S., Palatini P., Modesti P. A., Asayama K., Asmar R., Bilo G., De La Sierra A., Dolan E., Head G., Kario K., Kollias A., Manios E., Mihailidou A. S., Myers M., Niiranen T., Ohkubo T., Protogerou A., Wang J., O'Brien E., and Parati G.

Abstract

Blood pressure (BP) exhibits seasonal variation with lower levels at higher environmental temperatures and higher at lower temperatures. This is a global phenomenon affecting both sexes, all age groups, normotensive individuals, and hypertensive patients. In treated hypertensive patients it may result in excessive BP decline in summer, or rise in winter, possibly deserving treatment modification. This Consensus Statement by the European Society of Hypertension Working Group on BP Monitoring and Cardiovascular Variability provides a review of the evidence on the seasonal BP variation regarding its epidemiology, pathophysiology, relevance, magnitude, and the findings using different measurement methods. Consensus recommendations are provided for health professionals on how to evaluate the seasonal BP changes in treated hypertensive patients and when treatment modification might be justified. (i) In treated hypertensive patients symptoms appearing with temperature rise and suggesting overtreatment must be investigated for possible excessive BP drop due to seasonal variation. On the other hand, a BP rise during cold weather, might be due to seasonal variation. (ii) The seasonal BP changes should be confirmed by repeated office measurements; preferably with home or ambulatory BP monitoring. Other reasons for BP change must be excluded. (iii) Similar issues might appear in people traveling from cold to hot places, or the reverse. (iv) BP levels below the recommended treatment goal should be considered for possible down-titration, particularly if there are symptoms suggesting overtreatment. SBP less than 110 mmHg requires consideration for treatment down-titration, even in asymptomatic patients. Further research is needed on the optimal management of the seasonal BP changes.

Published
2020

17. Ambulatory blood pressure monitoring for risk stratification in obese and non-obese subjects from 10 populations

Author

Hansen, T W, Thijs, L, Li, Y, Boggia, J, Liu, Y, Asayama, K, Kikuya, M, Björklund-Bodegård, K, Ohkubo, T, Jeppesen, J, Torp-Pedersen, C, Dolan, E, Kuznetsova, T, Stolarz-Skrzypek, K, Tikhonoff, V, Malyutina, S, Casiglia, E, Nikitin, Y, Lind, L, Sandoya, E, Kawecka-Jaszcz, K, Filipovský, J, Imai, Y, Wang, J, O'Brien, E, and Staessen, J A

Published
2014
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20. Emergence of Home Blood Pressure-Guided Management of Hypertension Based on Global Evidence

Author

Kario, K, Shimbo, D, Hoshide, S, Wang, J, Asayama, K, Ohkubo, T, Imai, Y, Mcmanus, R, Kollias, A, Niiranen, T, Parati, G, Williams, B, Weber, M, Vongpatanasin, W, Muntner, P, Stergiou, G, Kario K., Shimbo D., Hoshide S., Wang J. -G., Asayama K., Ohkubo T., Imai Y., McManus R. J., Kollias A., Niiranen T. J., Parati G., Williams B., Weber M. A., Vongpatanasin W., Muntner P., Stergiou G. S., Kario, K, Shimbo, D, Hoshide, S, Wang, J, Asayama, K, Ohkubo, T, Imai, Y, Mcmanus, R, Kollias, A, Niiranen, T, Parati, G, Williams, B, Weber, M, Vongpatanasin, W, Muntner, P, Stergiou, G, Kario K., Shimbo D., Hoshide S., Wang J. -G., Asayama K., Ohkubo T., Imai Y., McManus R. J., Kollias A., Niiranen T. J., Parati G., Williams B., Weber M. A., Vongpatanasin W., Muntner P., and Stergiou G. S.

Published
2019

22. Home blood pressure monitoring: methodology, clinical relevance and practical application: a 2021 position paper by the Working Group on Blood Pressure Monitoring and Cardiovascular Variability of the European Society of Hypertension

Author

Parati, G, Stergiou, G, Bilo, G, Kollias, A, Pengo, M, Ochoa, J, Agarwal, R, Asayama, K, Asmar, R, Burnier, M, De La Sierra, A, Giannattasio, C, Gosse, P, Head, G, Hoshide, S, Imai, Y, Kario, K, Li, Y, Manios, E, Mant, J, Mcmanus, R, Mengden, T, Mihailidou, A, Muntner, P, Myers, M, Niiranen, T, Ntineri, A, O'Brien, E, Octavio, J, Ohkubo, T, Omboni, S, Padfield, P, Palatini, P, Pellegrini, D, Postel-Vinay, N, Ramirez, A, Sharman, J, Shennan, A, Silva, E, Topouchian, J, Torlasco, C, Wang, J, Weber, M, Whelton, P, White, W, Mancia, G, Parati, Gianfranco, Stergiou, George S, Bilo, Grzegorz, Kollias, Anastasios, Pengo, Martino, Ochoa, Juan Eugenio, Agarwal, Rajiv, Asayama, Kei, Asmar, Roland, Burnier, Michel, De La Sierra, Alejandro, Giannattasio, Cristina, Gosse, Philippe, Head, Geoffrey, Hoshide, Satoshi, Imai, Yutaka, Kario, Kazuomi, Li, Yan, Manios, Efstathios, Mant, Jonathan, McManus, Richard J, Mengden, Thomas, Mihailidou, Anastasia S, Muntner, Paul, Myers, Martin, Niiranen, Teemu, Ntineri, Angeliki, O'Brien, Eoin, Octavio, José Andres, Ohkubo, Takayoshi, Omboni, Stefano, Padfield, Paul, Palatini, Paolo, Pellegrini, Dario, Postel-Vinay, Nicolas, Ramirez, Agustin J, Sharman, James E, Shennan, Andrew, Silva, Egle, Topouchian, Jirar, Torlasco, Camilla, Wang, Ji Guang, Weber, Michael A, Whelton, Paul K, White, William B, Mancia, Giuseppe, Parati, G, Stergiou, G, Bilo, G, Kollias, A, Pengo, M, Ochoa, J, Agarwal, R, Asayama, K, Asmar, R, Burnier, M, De La Sierra, A, Giannattasio, C, Gosse, P, Head, G, Hoshide, S, Imai, Y, Kario, K, Li, Y, Manios, E, Mant, J, Mcmanus, R, Mengden, T, Mihailidou, A, Muntner, P, Myers, M, Niiranen, T, Ntineri, A, O'Brien, E, Octavio, J, Ohkubo, T, Omboni, S, Padfield, P, Palatini, P, Pellegrini, D, Postel-Vinay, N, Ramirez, A, Sharman, J, Shennan, A, Silva, E, Topouchian, J, Torlasco, C, Wang, J, Weber, M, Whelton, P, White, W, Mancia, G, Parati, Gianfranco, Stergiou, George S, Bilo, Grzegorz, Kollias, Anastasios, Pengo, Martino, Ochoa, Juan Eugenio, Agarwal, Rajiv, Asayama, Kei, Asmar, Roland, Burnier, Michel, De La Sierra, Alejandro, Giannattasio, Cristina, Gosse, Philippe, Head, Geoffrey, Hoshide, Satoshi, Imai, Yutaka, Kario, Kazuomi, Li, Yan, Manios, Efstathios, Mant, Jonathan, McManus, Richard J, Mengden, Thomas, Mihailidou, Anastasia S, Muntner, Paul, Myers, Martin, Niiranen, Teemu, Ntineri, Angeliki, O'Brien, Eoin, Octavio, José Andres, Ohkubo, Takayoshi, Omboni, Stefano, Padfield, Paul, Palatini, Paolo, Pellegrini, Dario, Postel-Vinay, Nicolas, Ramirez, Agustin J, Sharman, James E, Shennan, Andrew, Silva, Egle, Topouchian, Jirar, Torlasco, Camilla, Wang, Ji Guang, Weber, Michael A, Whelton, Paul K, White, William B, and Mancia, Giuseppe

Abstract

The present paper provides an update of previous recommendations on Home Blood Pressure Monitoring from the European Society of Hypertension (ESH) Working Group on Blood Pressure Monitoring and Cardiovascular Variability sequentially published in years 2000, 2008 and 2010. This update has taken into account new evidence in this field, including a recent statement by the American Heart association, as well as technological developments, which have occurred over the past 20 years. The present document has been developed by the same ESH Working Group with inputs from an international team of experts, and has been endorsed by the ESH.

Published
2021

24. Adiposity and risk of decline in glomerular filtration rate : Meta-analysis of individual participant data in a global consortium

Author

Chang AR, Grams ME, Ballew SH, Bilo H, Correa A, Evans M, Gutierrez OM, Hosseinpanah F, Iseki K, Kenealy T, Klein B, Kronenberg F, Lee BJ, Li Y, Miura K, Navaneethan SD, Roderick PJ, Valdivielso JM, Visseren FLJ, Zhang L, Gansevoort RT, Hallan SI, Levey AS, Matsushita K, Shalev V, Woodward M, Astor B, Appel L, Greene T, Chen T, Chalmers J, Arima H, Perkovic V, Yatsuya H, Tamakoshi K, Hirakawa Y, Coresh J, Sang Y, Polkinghorne K, Chadban S, Atkins R, Levin A, Djurdjev O, Klein R, Lee K, Liu L, Zhao M, Wang F, Wang J, Tang M, Heine G, Emrich I, Zawada A, Bauer L, Nally J, Schold J, Shlipak M, Sarnak M, Katz R, Hiramoto J, Iso H, Yamagishi K, Umesawa M, Muraki I, Fukagawa M, Maruyama S, Hamano T, Hasegawa T, Fujii N, Jafar T, Hatcher J, Poulter N, Chaturvedi N, Wheeler D, Emberson J, Townend J, Landray M, Brenner H, Schöttker B, Saum KU, Rothenbacher D, Fox C, Hwang SJ, Köttgen A, Schneider MP, Eckardt KU, Green J, Kirchner HL, Ito S, Miyazaki M, Nakayama M, Yamada G, Cirillo M, Romundstad S, Øvrehus M, Langlo KA, Irie F, Sairenchi T, Rebholz CM, Young B, Boulware LE, Ishikawa S, Yano Y, Kotani K, Nakamura T, Jee SH, Kimm H, Mok Y, Chodick G, Wetzels JFM, Blankestijn PJ, van Zuilen AD, Bots M, Inker L, Peralta C, Kollerits B, Ritz E, Nitsch D, Fletcher A, Bottinger E, Nadkarni GN, Ellis SB, Nadukuru R, Fernandez E, Betriu A, Bermudez-Lopez M, Stengel B, Metzger M, Flamant M, Houillier P, Haymann JP, Froissart M, Ueshima H, Okayama A, Tanaka S, Okamura T, Elley CR, Collins JF, Drury PL, Ohkubo T, Asayama K, Metoki H, Kikuya M, Iseki C, Nelson RG, Knowler WC, Bakker SJL, Heerspink HJL, Brunskill N, Major R, Shepherd D, Medcalf J, Jassal SK, Bergstrom J, Ix JH, Barrett-Connor E, Kovesdy C, Kalantar-Zadeh K, Sumida K, Muntner P, Warnock D, Judd S, Panwar B, de Zeeuw D, Brenner B, Sedaghat S, Ikram MA, Hoorn EJ, Dehghan A, Wong TY, Sabanayagam C, Cheng CY, Banu R, Segelmark M, Stendahl M, Schön S, Tangri N, Sud M, Naimark D, Wen CP, Tsao CK, Tsai MK, Chen CH, Konta T, Hirayama A, Ichikawa K, Hadaegh F, Mirbolouk M, Azizi F, Solbu MD, Jenssen TG, Eriksen BO, Eggen AE, Lannfelt L, Larsson A, Ärnlöv J, Landman GWD, van Hateren KJJ, Kleefstra N, Chen J, Kwak L, Surapaneni A., Chang, Ar, Grams, Me, Ballew, Sh, Bilo, H, Correa, A, Evans, M, Gutierrez, Om, Hosseinpanah F, Iseki K, Kenealy, T, Klein, B, Kronenberg, F, Lee, Bj, Li, Y, Miura, K, Navaneethan, Sd, Roderick, Pj, Valdivielso, Jm, Visseren, Flj, Zhang, L, Gansevoort, Rt, Hallan, Si, Levey, A, Matsushita, K, Shalev, V, Woodward, M, Astor, B, Appel, L, Greene, T, Chen, T, Chalmers, J, Arima, H, Perkovic, V, Yatsuya, H, Tamakoshi, K, Hirakawa, Y, Coresh, J, Sang, Y, Polkinghorne, K, Chadban, S, Atkins, R, Levin, A, Djurdjev, O, Klein, R, Lee, K, Liu, L, Zhao, M, Wang, F, Wang, J, Tang, M, Heine, G, Emrich, I, Zawada, A, Bauer, L, Nally, J, Schold, J, Shlipak, M, Sarnak, M, Katz, R, Hiramoto, J, Iso, H, Yamagishi, K, Umesawa, M, Muraki, I, Fukagawa, M, Maruyama, S, Hamano, T, Hasegawa, T, Fujii, N, Jafar, T, Hatcher, J, Poulter, N, Chaturvedi, N, Wheeler, D, Emberson, J, Townend, J, Landray, M, Brenner, H, Schöttker, B, Saum, Ku, Rothenbacher, D, Fox, C, Hwang, Sj, Köttgen, A, Schneider, Mp, Eckardt, Ku, Green, J, Kirchner, Hl, Ito, S, Miyazaki, M, Nakayama, M, Yamada, G, Cirillo, M, Romundstad, S, Øvrehus, M, Langlo, Ka, Irie, F, Sairenchi, T, Rebholz, Cm, Young, B, Boulware, Le, Ishikawa, S, Yano, Y, Kotani, K, Nakamura, T, Jee, Sh, Kimm, H, Mok, Y, Chodick, G, Wetzels, Jfm, Blankestijn, Pj, van Zuilen, Ad, Bots, M, Inker, L, Peralta, C, Kollerits, B, Ritz, E, Nitsch, D, Fletcher, A, Bottinger, E, Nadkarni, Gn, Ellis, Sb, Nadukuru, R, Fernandez, E, Betriu, A, Bermudez-Lopez, M, Stengel, B, Metzger, M, Flamant, M, Houillier, P, Haymann, Jp, Froissart, M, Ueshima, H, Okayama, A, Tanaka, S, Okamura, T, Elley, Cr, Collins, Jf, Drury, Pl, Ohkubo, T, Asayama, K, Metoki, H, Kikuya, M, Iseki, C, Nelson, Rg, Knowler, Wc, Bakker, Sjl, Heerspink, Hjl, Brunskill, N, Major, R, Shepherd, D, Medcalf, J, Jassal, Sk, Bergstrom, J, Ix, Jh, Barrett-Connor, E, Kovesdy, C, Kalantar-Zadeh, K, Sumida, K, Muntner, P, Warnock, D, Judd, S, Panwar, B, de Zeeuw, D, Brenner, B, Sedaghat, S, Ikram, Ma, Hoorn, Ej, Dehghan, A, Wong, Ty, Sabanayagam, C, Cheng, Cy, Banu, R, Segelmark, M, Stendahl, M, Schön, S, Tangri, N, Sud, M, Naimark, D, Wen, Cp, Tsao, Ck, Tsai, Mk, Chen, Ch, Konta, T, Hirayama, A, Ichikawa, K, Hadaegh, F, Mirbolouk, M, Azizi, F, Solbu, Md, Jenssen, Tg, Eriksen, Bo, Eggen, Ae, Lannfelt, L, Larsson, A, Ärnlöv, J, Landman, Gwd, van Hateren, Kjj, Kleefstra, N, Chen, J, Kwak, L, Surapaneni, A., Lifestyle Medicine (LM), Cardiovascular Centre (CVC), Groningen Kidney Center (GKC), Groningen Institute for Organ Transplantation (GIOT), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Asayama, Kei, and Sedaghat, SeyyedMah

Subjects
CHRONIC KIDNEY-DISEASE, Male, 030232 urology & nephrology, 030204 cardiovascular system & hematology, OBESITY PARADOX, Body Mass Index, BMI, eGFR, CKD-PC, Cohort Studies, 0302 clinical medicine, Risk Factors, Urologi och njurmedicin, Medicine, ALL-CAUSE MORTALITY, Adiposity, 2. Zero hunger, Aged, 80 and over, Medicine(all), education.field_of_study, Hazard ratio, ASSOCIATION, General Medicine, Middle Aged, 3. Good health, Cohort, Female, Waist Circumference, Life Sciences & Biomedicine, WAIST CIRCUMFERENCE, Obesity paradox, Glomerular Filtration Rate, Adult, Waist, Population, Renal function, 03 medical and health sciences, Medicine, General & Internal, General & Internal Medicine, CKD, Urology and Nephrology, Humans, Mortality, education, Aged, Science & Technology, business.industry, Research, medicine.disease, Body Height, BODY-MASS INDEX, Kidney Failure, Chronic, WEIGHT, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11], business, Body mass index, Demography, Kidney disease
Abstract

ObjectiveTo evaluate the associations between adiposity measures (body mass index, waist circumference, and waist-to-height ratio) with decline in glomerular filtration rate (GFR) and with all cause mortality.DesignIndividual participant data meta-analysis.SettingCohorts from 40 countries with data collected between 1970 and 2017.ParticipantsAdults in 39 general population cohorts (n=5 459 014), of which 21 (n=594 496) had data on waist circumference; six cohorts with high cardiovascular risk (n=84 417); and 18 cohorts with chronic kidney disease (n=91 607).Main outcome measuresGFR decline (estimated GFR decline ≥40%, initiation of kidney replacement therapy or estimated GFR 2) and all cause mortality.ResultsOver a mean follow-up of eight years, 246 607 (5.6%) individuals in the general population cohorts had GFR decline (18 118 (0.4%) end stage kidney disease events) and 782 329 (14.7%) died. Adjusting for age, sex, race, and current smoking, the hazard ratios for GFR decline comparing body mass indices 30, 35, and 40 with body mass index 25 were 1.18 (95% confidence interval 1.09 to 1.27), 1.69 (1.51 to 1.89), and 2.02 (1.80 to 2.27), respectively. Results were similar in all subgroups of estimated GFR. Associations weakened after adjustment for additional comorbidities, with respective hazard ratios of 1.03 (0.95 to 1.11), 1.28 (1.14 to 1.44), and 1.46 (1.28 to 1.67). The association between body mass index and death was J shaped, with the lowest risk at body mass index of 25. In the cohorts with high cardiovascular risk and chronic kidney disease (mean follow-up of six and four years, respectively), risk associations between higher body mass index and GFR decline were weaker than in the general population, and the association between body mass index and death was also J shaped, with the lowest risk between body mass index 25 and 30. In all cohort types, associations between higher waist circumference and higher waist-to-height ratio with GFR decline were similar to that of body mass index; however, increased risk of death was not associated with lower waist circumference or waist-to-height ratio, as was seen with body mass index.ConclusionsElevated body mass index, waist circumference, and waist-to-height ratio are independent risk factors for GFR decline and death in individuals who have normal or reduced levels of estimated GFR.

Published
2019

26. Seasonal variation in blood pressure: Evidence, consensus and recommendations for clinical practice. Consensus statement by the European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability

Author

Stergiou, G.S. Palatini, P. Modesti, P.A. Asayama, K. Asmar, R. Bilo, G. De La Sierra, A. Dolan, E. Head, G. Kario, K. Kollias, A. Manios, E. Mihailidou, A.S. Myers, M. Niiranen, T. Ohkubo, T. Protogerou, A. Wang, J. O'Brien, E. Parati, G.

Abstract

Blood pressure (BP) exhibits seasonal variation with lower levels at higher environmental temperatures and higher at lower temperatures. This is a global phenomenon affecting both sexes, all age groups, normotensive individuals, and hypertensive patients. In treated hypertensive patients it may result in excessive BP decline in summer, or rise in winter, possibly deserving treatment modification. This Consensus Statement by the European Society of Hypertension Working Group on BP Monitoring and Cardiovascular Variability provides a review of the evidence on the seasonal BP variation regarding its epidemiology, pathophysiology, relevance, magnitude, and the findings using different measurement methods. Consensus recommendations are provided for health professionals on how to evaluate the seasonal BP changes in treated hypertensive patients and when treatment modification might be justified. (i) In treated hypertensive patients symptoms appearing with temperature rise and suggesting overtreatment must be investigated for possible excessive BP drop due to seasonal variation. On the other hand, a BP rise during cold weather, might be due to seasonal variation. (ii) The seasonal BP changes should be confirmed by repeated office measurements; preferably with home or ambulatory BP monitoring. Other reasons for BP change must be excluded. (iii) Similar issues might appear in people traveling from cold to hot places, or the reverse. (iv) BP levels below the recommended treatment goal should be considered for possible down-titration, particularly if there are symptoms suggesting overtreatment. SBP less than 110 mmHg requires consideration for treatment down-titration, even in asymptomatic patients. Further research is needed on the optimal management of the seasonal BP changes. © 2020 Lippincott Williams and Wilkins. All rights reserved.

Published
2020

33. Opposing age-related trends in absolute and relative risk of adverse health outcomes associated with out-of-office blood pressure

Author

Li, Y. Thijs, L. Zhang, Z.-Y. Asayama, K. Hansen, T.W. Boggia, J. Björklund-Bodegård, K. Yang, W.-Y. Niiranen, T.J. Ntineri, A. Wei, F.-F. Kikuya, M. Ohkubo, T. Dolan, E. Hozawa, A. Tsuji, I. Stolarz-Skrzypek, K. Huang, Q.-F. Melgarejo, J.D. Tikhonoff, V. Malyutina, S. Casiglia, E. Nikitin, Y. Lind, L. Sandoya, E. Aparicio, L. Barochiner, J. Gilis-Malinowska, N. Narkiewicz, K. Kawecka-Jaszcz, K. Maestre, G.E. Jula, A.M. Johansson, J.K. Kuznetsova, T. Filipovský, J. Stergiou, G. Wang, J.-G. Imai, Y. O'Brien, E. Staessen, J.A.

Abstract

Participant-level meta-analyses assessed the age-specific relevance of office blood pressure to cardiovascular complications, but this information is lacking for out-of-office blood pressure. At baseline, daytime ambulatory (n=12 624) or home (n=5297) blood pressure were measured in 17 921 participants (51.3% women; mean age, 54.2 years) from 17 population cohorts. Subsequently, mortality and cardiovascular events were recorded. Using multivariable Cox regression, floating absolute risk was computed across 4 age bands (≤60, 61-70, 71-80, and >80 years). Over 236 491 person-years, 3855 people died and 2942 cardiovascular events occurred. From levels as low as 110/65 mm Hg, risk log-linearly increased with higher out-of-office systolic/diastolic blood pressure. From the youngest to the oldest age group, rates expressed per 1000 person-years increased (P

Published
2019

34. Nocturnal blood pressuremeasured by home devices: Evidence and perspective for clinical application

Author

Asayama, K. Fujiwara, T. Hoshide, S. Ohkubo, T. Kario, K. Stergiou, G.S. Parati, G. White, W.B. Weber, M.A. Imai, Y.

Abstract

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. © 2018 The Author(s).

Published
2019

40. Association of Office and Ambulatory Blood Pressure With Mortality and Cardiovascular Outcomes

Author

Yang, Wen-Yi, Melgarejo, Jesus D., Thijs, Lutgarde, Zhang, Zhen-Yu, Boggia, Jose, Wei, Fang-Fei, Hansen, Tine W., Asayama, Kei, Ohkubo, Takayoshi, Jeppesen, Jorgen, Dolan, Eamon, Stolarz-Skrzypek, Katarzyna, Malyutina, Sofia, Casiglia, Edoardo, Lind, Lars, Filipovsky, Jan, Maestre, Gladys E., Li, Yan, Wang, Ji-Guang, Imai, Yutaka, Kawecka-Jaszcz, Kalina, Sandoya, Edgardo, Narkiewicz, Krzysztof, O'Brien, Eoin, Verhamme, Peter, Staessen, Jan A., Mujaj, B., Cauwenberghs, N., Kuznetsova, T., Thijs, L., Staessen, J. A., Wei, F. -F, Yang, W. -Y, Yu, C. -G, Zhang, Z. -Y, Li, Y., Sheng, C. -S, Huang, Q. -F, Wang, J. -G, Filipovsky, J., Seidlerova, J., Ticha, M., Hansen, T. W., Ibsen, H., Jeppesen, J., Rasmussen, S., Torp-Pedersen, C., Dolan, E., O'Brien, E., Casiglia, E., Pizzioli, A., Tikhonoff, V., Asayama, K., Hashimoto, J., Hoshi, H., Imai, Y., Inoue, R., Kikuya, M., Metoki, H., Obara, T., Ohkubo, T., Satoh, H., Totsune, K., Gilis-Malinowska, N., Narkiewicz, K., Adamkiewicz-Piejko, A., Cwynar, M., Gasowski, J., Grodzicki, T., Kawecka-Jaszcz, K., Lubaszewski, W., Olszanecka, A., Stolarz-Skrzypek, K., Wizner, B., Wojciechowska, W., Zyczkowska, J., Malyutina, S., Nikitin, Y., Pello, E., Simonova, G., Voevoda, M., Andren, B., Berglund, L., Bjorklund-Bodegard, K., Lind, L., Zethelius, B., Bianchi, M., Boggia, J., Moreira, V., Sandoya, E., Schettini, C., Schwedt, E., Senra, H., Maestre, G., Melgarejo, J. D., Yang, Wen-Yi, Melgarejo, Jesus D., Thijs, Lutgarde, Zhang, Zhen-Yu, Boggia, Jose, Wei, Fang-Fei, Hansen, Tine W., Asayama, Kei, Ohkubo, Takayoshi, Jeppesen, Jorgen, Dolan, Eamon, Stolarz-Skrzypek, Katarzyna, Malyutina, Sofia, Casiglia, Edoardo, Lind, Lars, Filipovsky, Jan, Maestre, Gladys E., Li, Yan, Wang, Ji-Guang, Imai, Yutaka, Kawecka-Jaszcz, Kalina, Sandoya, Edgardo, Narkiewicz, Krzysztof, O'Brien, Eoin, Verhamme, Peter, Staessen, Jan A., Mujaj, B., Cauwenberghs, N., Kuznetsova, T., Thijs, L., Staessen, J. A., Wei, F. -F, Yang, W. -Y, Yu, C. -G, Zhang, Z. -Y, Li, Y., Sheng, C. -S, Huang, Q. -F, Wang, J. -G, Filipovsky, J., Seidlerova, J., Ticha, M., Hansen, T. W., Ibsen, H., Jeppesen, J., Rasmussen, S., Torp-Pedersen, C., Dolan, E., O'Brien, E., Casiglia, E., Pizzioli, A., Tikhonoff, V., Asayama, K., Hashimoto, J., Hoshi, H., Imai, Y., Inoue, R., Kikuya, M., Metoki, H., Obara, T., Ohkubo, T., Satoh, H., Totsune, K., Gilis-Malinowska, N., Narkiewicz, K., Adamkiewicz-Piejko, A., Cwynar, M., Gasowski, J., Grodzicki, T., Kawecka-Jaszcz, K., Lubaszewski, W., Olszanecka, A., Stolarz-Skrzypek, K., Wizner, B., Wojciechowska, W., Zyczkowska, J., Malyutina, S., Nikitin, Y., Pello, E., Simonova, G., Voevoda, M., Andren, B., Berglund, L., Bjorklund-Bodegard, K., Lind, L., Zethelius, B., Bianchi, M., Boggia, J., Moreira, V., Sandoya, E., Schettini, C., Schwedt, E., Senra, H., Maestre, G., and Melgarejo, J. D.

Abstract

ImportanceBlood pressure (BP) is a known risk factor for overall mortality and cardiovascular (CV)-specific fatal and nonfatal outcomes. It is uncertain which BP index is most strongly associated with these outcomes. ObjectiveTo evaluate the association of BP indexes with death and a composite CV event. Design, Setting, and ParticipantsLongitudinal population-based cohort study of 11135 adults from Europe, Asia, and South America with baseline observations collected from May 1988 to May 2010 (last follow-ups, August 2006-October 2016). ExposuresBlood pressure measured by an observer or an automated office machine; measured for 24 hours, during the day or the night; and the dipping ratio (nighttime divided by daytime readings). Main Outcomes and MeasuresMultivariable-adjusted hazard ratios (HRs) expressed the risk of death or a CV event associated with BP increments of 20/10 mm Hg. Cardiovascular events included CV mortality combined with nonfatal coronary events, heart failure, and stroke. Improvement in model performance was assessed by the change in the area under the curve (AUC). ResultsAmong 11135 participants (median age, 54.7 years, 49.3% women), 2836 participants died (18.5 per 1000 person-years) and 2049 (13.4 per 1000 person-years) experienced a CV event over a median of 13.8 years of follow-up. Both end points were significantly associated with all single systolic BP indexes (P<.001). For nighttime systolic BP level, the HR for total mortality was 1.23 (95% CI, 1.17-1.28) and for CV events, 1.36 (95% CI, 1.30-1.43). For the 24-hour systolic BP level, the HR for total mortality was 1.22 (95% CI, 1.16-1.28) and for CV events, 1.45 (95% CI, 1.37-1.54). With adjustment for any of the other systolic BP indexes, the associations of nighttime and 24-hour systolic BP with the primary outcomes remained statistically significant (HRs ranging from 1.17 [95% CI, 1.10-1.25] to 1.87 [95% CI, 1.62-2.16]). Base models that included single systolic BP indexes yielded an

Published
2019
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