The current status of home and office blood pressure control among hypertensive patients with diabetes mellitus: The Japan Home Versus Office Blood Pressure Measurement Evaluation (J-HOME) study

Obara, Taku; Ohkubo, Takayoshi; Kikuya, Masahiro; Asayama, Kei; Metoki, Hirohito; Inoue, Ryusuke; Oikawa, Takuya; Murai, Kayo; Komai, Rie; Horikawa, Tsuyoshi; Hashimoto, Junichiro; Totsune, Kazuhito; Imai, Yutaka; The J-HOME Study Group,

doi:10.1016/j.diabres.2006.01.015

« Previous Next »Diabetes Research and Clinical Practice
Volume 73, Issue 3 , Pages 276-283, September 2006

The current status of home and office blood pressure control among hypertensive patients with diabetes mellitus: The Japan Home Versus Office Blood Pressure Measurement Evaluation (J-HOME) study

Taku Obara
- Departments of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Science and Medicine, Tohoku University Hospital, 1-1 Seiryo-cho, Aoba-ku, Sendai 980-8574, Japan
- Tohoku University 21st Century COE Program “Comprehensive Research and Education Center for Planning of Drug Development and Clinical Evaluation”, Sendai, Japan
Takayoshi Ohkubo
- Departments of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Science, Sendai, Japan
- Tohoku University 21st Century COE Program “Comprehensive Research and Education Center for Planning of Drug Development and Clinical Evaluation”, Sendai, Japan
Masahiro Kikuya
- Departments of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Science, Sendai, Japan
Kei Asayama
- Departments of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Science and Medicine, Tohoku University Hospital, 1-1 Seiryo-cho, Aoba-ku, Sendai 980-8574, Japan
- Tohoku University 21st Century COE Program “Comprehensive Research and Education Center for Planning of Drug Development and Clinical Evaluation”, Sendai, Japan
Hirohito Metoki
- Departments of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Science and Medicine, Tohoku University Hospital, 1-1 Seiryo-cho, Aoba-ku, Sendai 980-8574, Japan
- Tohoku University 21st Century COE Program “Comprehensive Research and Education Center for Planning of Drug Development and Clinical Evaluation”, Sendai, Japan
Ryusuke Inoue
- Tohoku University 21st Century COE Program “Comprehensive Research and Education Center for Planning of Drug Development and Clinical Evaluation”, Sendai, Japan
Takuya Oikawa
- Departments of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Science and Medicine, Tohoku University Hospital, 1-1 Seiryo-cho, Aoba-ku, Sendai 980-8574, Japan
Kayo Murai
- Departments of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Science and Medicine, Tohoku University Hospital, 1-1 Seiryo-cho, Aoba-ku, Sendai 980-8574, Japan
Rie Komai
- Departments of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Science and Medicine, Tohoku University Hospital, 1-1 Seiryo-cho, Aoba-ku, Sendai 980-8574, Japan
Tsuyoshi Horikawa
- Departments of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Science and Medicine, Tohoku University Hospital, 1-1 Seiryo-cho, Aoba-ku, Sendai 980-8574, Japan
Junichiro Hashimoto
- Departments of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Science, Sendai, Japan
- Tohoku University 21st Century COE Program “Comprehensive Research and Education Center for Planning of Drug Development and Clinical Evaluation”, Sendai, Japan
Kazuhito Totsune
- Departments of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Science and Medicine, Tohoku University Hospital, 1-1 Seiryo-cho, Aoba-ku, Sendai 980-8574, Japan
- Tohoku University 21st Century COE Program “Comprehensive Research and Education Center for Planning of Drug Development and Clinical Evaluation”, Sendai, Japan
Yutaka Imai
- Departments of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Science and Medicine, Tohoku University Hospital, 1-1 Seiryo-cho, Aoba-ku, Sendai 980-8574, Japan
- Tohoku University 21st Century COE Program “Comprehensive Research and Education Center for Planning of Drug Development and Clinical Evaluation”, Sendai, Japan
- Corresponding author. Tel.: +81 22 717 7770; fax: +81 22 717 7776.
The J-HOME Study Group
- See Appendix A.

Received 20 October 2005; received in revised form 19 December 2005; accepted 31 January 2006. published online 03 April 2006.

Abstract

Although self-measured blood pressure (BP) at home (HBP) has become popular in clinical practice, little information is available regarding the proportion of diabetic patients with properly controlled HBP. We evaluated the status of HBP control in diabetic hypertensives. HBP control status was cross-sectionally evaluated among 3400 essential hypertensives taking antihypertensive treatment. Of these, 466 (14%) had diabetes. Physicians evaluated the subjects’ HBP control as “poor”, “fairly good”, or “excellent” using a self-administered questionnaire.

When the HBP threshold in diabetic patients was set tentatively at 130/80mmHg or 135/85mmHg, HBP was properly controlled in 18% or 30% of diabetic patients, respectively. The same trend was observed in office BP. The average number of drugs prescribed for diabetic patients was 2.0 drugs. In the majority of diabetic patients with uncontrolled BP, the BP control status in two-thirds of those was evaluated as “excellent” or “fairly good” by their physicians. In Japan, HBP and office BP were not adequately controlled in most diabetic hypertensives. The main reason for this would appear to be a lack of intensive treatment and a lack of recognition by physicians that their patients’ BP was insufficiently controlled.