Optimal Number of Days for Home Blood Pressure Measurement

Teemu J. Niiranen, Kei Asayama, Lutgarde Thijs, Jouni K. Johansson, Azusa Hara, Atsushi Hozawa, Ichiro Tsuji, Takayoshi Ohkubo, Antti M. Jula, Yutaka Imai, Jan A. Staessen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


BACKGROUND Current guidelines make no outcome-based recommendations on the optimal measurement schedule for home blood pressure (BP). METHODS We enrolled 4,802 randomly recruited participants from three populations. The participants were classified by their (i) cross-classification according to office and home BP (normotension, masked hypertension, white-coat hypertension, and sustained hypertension) and (ii) home BP level (normal BP, high normal BP, grade 1 and 2 hypertension), while the number of home measurement days was increased from 1 to 7. The prognostic accuracy of home BP with an increasing number of home BP measurement days was also assessed by multivariable-adjusted Cox models. RESULTS Agreement in classification between consecutive measurement days indicated near perfect agreement (kappa >= 0.9) after the sixth measurement day for both office and home BP cross-classification (97.8% maintained classification, kappa = 0.97) and home BP level (93.6% maintained classification, kappa = 0.91). Over a follow-up of 8.3 years, 568 participants experienced a cardiovascular event, and the first home BP measurement alone predicted events significantly (P
Original languageEnglish
Pages (from-to)595-603
JournalAmerican Journal of Hypertension
Issue number5
Publication statusPublished - May 2015


  • blood pressure
  • cardiovascular diseases
  • home blood pressure monitoring
  • hypertension
  • meta-analysis
  • prognosis


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