{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:01:45Z","timestamp":1785772905417,"version":"3.56.0"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2016,3,9]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Recent literature suggests that blood pressure variability (\n              <jats:styled-content style=\"fixed-case\">BPV<\/jats:styled-content>\n              ) predicts outcome beyond blood pressure level (\n              <jats:styled-content style=\"fixed-case\">BPL<\/jats:styled-content>\n              ) and that antihypertensive drug classes differentially influence\n              <jats:styled-content style=\"fixed-case\">BPV<\/jats:styled-content>\n              . We compared calcium channel blockers, angiotensin\u2010converting enzyme inhibitors, and angiotensin receptor blockade for effects on changes in self\u2010measured home\n              <jats:styled-content style=\"fixed-case\">BPL<\/jats:styled-content>\n              and\n              <jats:styled-content style=\"fixed-case\">BPV<\/jats:styled-content>\n              and for their prognostic significance in newly treated hypertensive patients.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We enrolled 2484 patients randomly allocated to first\u2010line treatment with a calcium channel blocker (n=833), an angiotensin\u2010converting enzyme inhibitor (n=821), or angiotensin receptor blockade (n=830). Home blood pressures in the morning and evening were measured for 5\u00a0days off treatment before randomization and for 5\u00a0days after 2 to 4\u00a0weeks of randomized drug treatment. We assessed\n              <jats:styled-content style=\"fixed-case\">BPL<\/jats:styled-content>\n              and\n              <jats:styled-content style=\"fixed-case\">BPV<\/jats:styled-content>\n              changes as estimated by variability independent of the mean and compared cardiovascular outcomes. Home\n              <jats:styled-content style=\"fixed-case\">BPL<\/jats:styled-content>\n              response in each group was significant (\n              <jats:italic>P<\/jats:italic>\n              \u22640.0001) but small in the angiotensin\u2010converting enzyme inhibitor group (systolic\/diastolic: 4.6\/2.8\u00a0mm\u00a0Hg) compared with the groups treated with a calcium channel blocker (systolic\/diastolic: 8.3\/3.9\u00a0mm\u00a0Hg) and angiotensin receptor blockade (systolic\/diastolic: 8.2\/4.5\u00a0mm\u00a0Hg). In multivariable adjusted analyses, changes in home variability independent of the mean did not differ among the 3 drug classes (\n              <jats:italic>P<\/jats:italic>\n              \u22650.054). Evening variability independent of the mean before treatment significantly predicted hard cardiovascular events independent of the corresponding home\n              <jats:styled-content style=\"fixed-case\">BPL<\/jats:styled-content>\n              (\n              <jats:italic>P<\/jats:italic>\n              \u22640.022), whereas\n              <jats:styled-content style=\"fixed-case\">BPV<\/jats:styled-content>\n              did not predict any cardiovascular outcome based on the morning measurement (\n              <jats:italic>P<\/jats:italic>\n              \u22650.056). Home\n              <jats:styled-content style=\"fixed-case\">BPV<\/jats:styled-content>\n              captured after monotherapy had no predictive power for cardiovascular outcome (\n              <jats:italic>P<\/jats:italic>\n              \u22650.22).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Self\u2010measured home evening\n              <jats:styled-content style=\"fixed-case\">BPV<\/jats:styled-content>\n              estimated by variability independent of the mean had prognostic significance, whereas antihypertensive drug classes had no significant impact on\n              <jats:styled-content style=\"fixed-case\">BPV<\/jats:styled-content>\n              changes. Home\n              <jats:styled-content style=\"fixed-case\">BPL<\/jats:styled-content>\n              should remain the primary focus for risk stratification and treatment.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Clinical Trial Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              <jats:styled-content style=\"fixed-case\">URL<\/jats:styled-content>\n              :\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.umin.ac.jp\/ctr\/index.htm\">http:\/\/www.umin.ac.jp\/ctr\/index.htm<\/jats:ext-link>\n              . Unique identifier: C000000137.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.115.002995","type":"journal-article","created":{"date-parts":[[2016,3,24]],"date-time":"2016-03-24T03:50:34Z","timestamp":1458791434000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":30,"title":["Does Antihypertensive Drug Class Affect Day\u2010to\u2010Day Variability of Self\u2010Measured Home Blood Pressure? The HOMED\u2010BP Study"],"prefix":"10.1161","volume":"5","author":[{"given":"Kei","family":"Asayama","sequence":"first","affiliation":[{"name":"Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan"},{"name":"Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayoshi","family":"Ohkubo","sequence":"additional","affiliation":[{"name":"Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan"},{"name":"Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiro","family":"Hanazawa","sequence":"additional","affiliation":[{"name":"Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan"},{"name":"Japan Development and Medical Affairs, GlaxoSmithKline KK, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Watabe","sequence":"additional","affiliation":[{"name":"Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan"},{"name":"Department of Pharmacy, National Cancer Center Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miki","family":"Hosaka","sequence":"additional","affiliation":[{"name":"Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michihiro","family":"Satoh","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisaku","family":"Yasui","sequence":"additional","affiliation":[{"name":"Embassy of Japan, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan A.","family":"Staessen","sequence":"additional","affiliation":[{"name":"Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium"},{"name":"R&amp;D VitaK Group, Maastricht University, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaka","family":"Imai","sequence":"additional","affiliation":[{"name":"Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Hypertensive Objective Treatment Based on Measurement by Electrical Devices of Blood Pressure (HOMED\u2010BP) Study Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/MBP.0b013e3283108f93"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.107.189010"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60308-X"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0103169"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.111.00138"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.111.178657"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60235-8"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.114.005982"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0b013e328361732c"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1038\/hr.2012.125"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.3109\/08037059209077502"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1997.03540350075038"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/00126097-200202000-00016"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/00126097-200108000-00008"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/00126097-200104000-00007"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.2217\/pgs.13.161"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0b013e328353f1fe"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.2040-1124.2010.00074.x"},{"key":"e_1_3_5_20_2","unstructured":"World Health Organization . 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