BACKGROUND Home blood pressure (BP) is more closely associated with cardiovascular event risk than office BP, but cardiovascular risk prediction based on home BP variability is lacking. This study developed a simple cardiovascular event prediction score, including home BP variability data, from the J-HOP study (Japan Morning Surge-Home Blood Pressure). METHODS The J-HOP study extended follow-up from December 2017 to May 2018 generated the study data set (4231 patients). Cardiovascular events included fatal/nonfatal stroke (n=94), coronary heart disease (n=124), heart failure (n=42), and aortic dissection (n=8). Cox proportional hazards models were used to predict overall cardiovascular risk. Potential covariates included age, sex, body mass index, smoking, history of diabetes, statin use, history of cardiovascular disease, total cholesterol:high-density lipoprotein cholesterol ratio, office systolic BP (SBP), mean of morning-evening average (MEave), home SBP, and average real variability of MEave home SBP. A risk score and models were constructed, and model performance was assessed. RESULTS Model performance was best when average real variability of MEave SBP was included (C statistic, 0.760). The risk score assigns points for age (5-year bands), sex, cardiovascular disease history, high-density lipoprotein cholesterol, mean MEave home SBP, and average real variability of MEave home SBP. Estimated 10-year cardiovascular risk ranged from ≤0.6% (score ≤0) to >32% (score ≥26). Calibration 2 statistics values for the model (2.66) and risk score (5.29) indicated excellent goodness of fit. CONCLUSIONS This simple cardiovascular disease prediction algorithm, including day-by-day home BP variability, could be used as part of a home BP-centered approach to hypertension management in clinical practice.

中文翻译：

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使用 J-HOP 研究的数据对心血管疾病的家庭血压变异风险预测评分。


背景家庭血压（BP）比办公室血压与心血管事件风险的相关性更密切，但缺乏基于家庭血压变异性的心血管风险预测。本研究开发了一个简单的心血管事件预测评分，包括来自 J-HOP 研究（日本晨间激增-家庭血压）的家庭血压变异性数据。方法 J-HOP 研究从 2017 年 12 月延长随访至 2018 年 5 月，生成研究数据集（4231 名患者）。心血管事件包括致命/非致命中风（n=94）、冠心病（n=124）、心力衰竭（n=42）和主动脉夹层（n=8）。 Cox比例风险模型用于预测总体心血管风险。潜在的协变量包括年龄、性别、体重指数、吸烟、糖尿病史、他汀类药物使用、心血管疾病史、总胆固醇：高密度脂蛋白胆固醇比率、办公室收缩压（SBP）、早晚平均值（MEave） )、家庭 SBP 以及 MEave 家庭 SBP 的平均实际变异性。构建了风险评分和模型，并评估了模型性能。结果 当包含 MEave SBP 的平均真实变异性时，模型性能最佳（C 统计量，0.760）。风险评分根据年龄（5 年范围）、性别、心血管疾病史、高密度脂蛋白胆固醇、平均 MEave 家庭 SBP 以及 MEave 家庭 SBP 的平均实际变异性进行评分。估计 10 年心血管风险范围为 ≤0.6%（分数 ≤0）至 >32%（分数 ≥26）。模型的校准 2 统计值 (2.66) 和风险评分 (5.29) 表明拟合优度极佳。 结论 这种简单的心血管疾病预测算法（包括每日家庭血压变异性）可以用作临床实践中以家庭血压为中心的高血压管理方法的一部分。