Sleep Blood Pressure Self‐Measured at Home as a Novel Determinant of Organ Damage: Japan Morning Surge Home Blood Pressure (J‐ HOP ) Study

To study whether sleep blood pressure ( BP ) self‐measured at home is associated with organ damage, the authors analyzed the data of 2562 participants in the J‐ HOP study who self‐measured sleep BP using a home BP monitoring ( HBPM ) device, three times during sleep (2  am , 3  am , 4  am ), as well as the home morning and evening BP s. The mean sleep home systolic BP s (SBPs) were all correlated with urinary albumin/creatinine ratio ( UACR ), left ventricular mass index ( LVMI ), brachial‐ankle pulse wave velocity (ba PWV ), maximum carotid intima‐media thickness, and plasma N‐terminal pro‐hormone pro–brain‐type natriuretic peptide (NTproBNP) (all P <.001). After controlling for clinic SBP and home morning and evening SBP s, associations of home sleep SBP with UACR , LVMI , and ba PWV remained significant (all P <.008). Even in patients with home morning BP <135/85 mm Hg, 27% exhibited masked nocturnal hypertension with home sleep SBP ≥120 mm Hg and had higher UACR and NT pro BNP . Masked nocturnal hypertension, which is associated with advanced organ damage, remains unrecognized by conventional HBPM .