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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EMorning systolic blood pressure (SBP) is associated with increased risk of cerebrovascular events, even if clinic SBP is low. This article presents data from the Home Blood Pressure Measurement With Olmesartan Naive Patients to Establish Standard Target Blood Pressure study [HONEST; UMIN000002567; Saito I et al. \u003Cem\u003EHypertens Res\u003C\/em\u003E 2013].\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ECerebrovascular Disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHypertensive Disease\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ECerebrovascular Disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHypertensive Disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EMorning systolic blood pressure (SBP) is associated with increased risk of cerebrovascular events, even if clinic SBP is low. Kazuomi Kario, MD, PhD, Jichi Medical University School of Medicine, Shimotsuke, Japan, presented data from the Home Blood Pressure Measurement With Olmesartan Naive Patients to Establish Standard Target Blood Pressure study [HONEST; UMIN000002567; Saito I et al. \u003Cem\u003EHypertens Res\u003C\/em\u003E 2013].\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EHome blood pressure (BP) monitoring is the first step in achieving 24-hour BP control [Shimamoto K et al. \u003Cem\u003EHypertens Res\u003C\/em\u003E 2014]. Morning hypertension\u2014defined as BP \u2265135\/85 mm Hg in the morning\u2014is a recommended target in clinical practice, by having patients take their antihypertensive medication in the morning [Kario K. \u003Cem\u003EAm J Hypertens\u003C\/em\u003E 2005]. The purpose of the HONEST study was to determine the effect of home BP, clinic BP, and the occurrence of cardiovascular events.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EIn the large prospective observational HONEST study, 21,591 olmesartan-na\u00efve patients with essential hypertension who had data for 2 days of morning home and clinic BP were followed for 2 years. At baseline, the mean age was 65 years, the body mass index was 24 kg\/m\u003Csup\u003E2\u003C\/sup\u003E, and 50% of participants had previously used antihypertensive therapy. All patients received olmesartan at baseline (mean dose, 18.2 mg), and 83% continued its use by the end of the study (mean dose, 20 mg). The primary end points included cerebrovascular event, cardiac event, and sudden death.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EMorning home SBP and clinic SBP were significantly associated with reaching the primary end point at 18 months (p=0.015 and p=0.0005, respectively) and 24 months (p\u22640.0001 for both). According to a spline regression analysis, the minimum risk for morning home SBP and clinic SBP was 124 mm Hg and 131 mm Hg, respectively. Patients with morning home SBP \u2265145 mm Hg and clinic SBP \u2265150 mm Hg had the greatest risk of reaching the primary end point (HR, 3.92; p\u0026lt;0.0001), with patients having morning home SBP \u2265145 mm Hg and clinic SBP \u0026lt;130 mm Hg also having significant risk for reaching the primary end point (HR, 2.47; p=0.014).\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EThere were no significant differences between morning home SBP and clinic SBP and between morning home diastolic BP (DBP) and clinic DBP, over the 2 years of follow-up. In addition, morning home and clinic BPs decreased by 20 and 10 mm Hg, respectively, at 2 years. The incidence of the primary end point was 6.46 (95% CI, 5.75 to 7.27), with a stroke incidence of 2.92 (95% CI, 2.46 to 3.48). In addition, the incidence of cardiac events was 3.85 (95% CI, 3.30 to 4.48), including a myocardial infarction incidence of 1.03 (95% CI, 0.77 to 1.38). The incidence for sudden death was 0.80 (95% CI, 0.58 to 1.12).\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EDr. Kario concluded that data from the HONEST study suggest that on-treatment morning home SBP \u0026gt;145 mm Hg is associated with an increase in risk of cardiovascular events at 2 years. In addition, the risk is high for patients who have masked hypertension (ie, those patients who have high home BP but low clinic BP).\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/18\/16.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzp1b3\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}