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

Invited Review

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

Takayoshi Ohkubo1,2 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


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.