Prognostic Significance of Home and Ambulatory Blood Pressure: Summary of Longitudinal Evidence from the Ohasama Study

Invited Review

Prognostic Significance of Home and Ambulatory Blood Pressure: Summary of Longitudinal Evidence from the Ohasama Study

Takayoshi Ohkubo^1,2 and Michihiro Satoh³

¹Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
²Tohoku Institute for Management of Blood Pressure, Sendai, Miyagi, Japan
³Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Miyagi, Japan

The Ohasama Study is a long-term prospective cohort study of the general population in the town of Ohasama (currently, Hanamaki city) in Iwate Prefecture, Japan, that was started in 1986. Ohasama is a typical farming village in the Tohoku region that consists of part-time farming households that cultivate mainly fruit trees. At the start of the study, the prevention of hypertension, a main cause of strokes, was taken to be an important issue in public health activities because of the many people who died or needed care as a result of strokes in Ohasama. A home blood pressure measurement program was then begun with the aim of preventing hypertension while increasing a sense of solidarity among community residents and the awareness that "one must protect one's own health." As a result, this project became the world's first community-based epidemiological study using home blood pressure, as well as 24-hour ambulatory blood pressure, for which measurements were also initiated. In the 1990s, the Ohasama Study reported a linear "the lower, the better" relationship between out-of-office blood pressure and cardiovascular risk. To date, we have accumulated advanced evidence regarding the clinical significance of out-of-office blood pressure. Those have contributed to hypertension management guidelines around the world. This article summarizes the results of representative long-term follow-up studies of the Ohasama Study.

Key words —— ambulatory; blood pressure monitoring; epidemiology; home blood pressure; review

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Tohoku J. Exp. Med., 2023 August, 260(4), 273-282.

Correspondence: Takayoshi Ohkubo, M.D., Ph.D., Department of Hygiene and Public Health, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan.

e-mail: tohkubo@med.teikyo-u.ac.jp