{"id":"30bb6d15a20a","type":"article","url":"https://hartvaat.nl/2026/04/09/thuis-bloeddruk-time-in-target-range-hoger-percentage-in-doel-geassocieerd-met-m/","title":"Thuis-bloeddruk-time-in-target-range: hoger percentage in doel geassocieerd met minder hersenlaesies","title_en":"IoT-Based Home Blood Pressure Time in Target Range and Brain Lesions on MRI","category":"hypertensie","category_label":"Hypertensie","professions":["cardioloog","huisarts","internist"],"tags":[],"journal":"Hypertension","doi":"https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26519","source_url":"https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26519","authors":["Takashi Hisamatsu"],"significance":6,"published":"2026-05-22","source_date":"2026-04-09","image":"","kennis":["https://hartvaat.nl/kennis/hypertensie/cardiovasculaire-risicoschatting-score2/","https://hartvaat.nl/kennis/nierziekte/nierziekte-en-cardiovasculair-risico/"],"congress":"","summary_en":"Cohort study (n=306, mean age 56 years, 57% women) relating Internet-of-Things-based home blood pressure (measured twice daily for a year) to subclinical cerebrovascular damage on MRI (lacunar infarcts, white matter hyperintensities, microbleeds, intracranial artery stenosis). Median annual Time in Target Range was 100% in untreated participants but only 1.9% in those on antihypertensive medication — a striking signal that office-based BP control overstates real-world regulation. Each 10% higher TTR was associated with a 15% lower prevalence of brain lesions (prevalence ratio 0.85; 95% CI 0.79-0.91), with a stronger effect in untreated individuals. TTR was lower in winter than summer. Home BP TTR may be a valuable complement to office measurement for assessing cerebrovascular health.","created":"2026-07-03T10:32:57Z","updated":"2026-07-03T13:31:52Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Cohortstudie (n=306, gemiddelde leeftijd 56 jaar, 57% vrouw) waarin Internet-of-Things-thuisbloeddrukmeting tweemaal daags gedurende een jaar werd gerelateerd aan subklinische cerebrovasculaire schade op MRI (lacunaire infarcten, white matter hyperintensities, microbleeds, intracraniële arteriestenose). De mediane jaarlijkse Time in Target Range bedroeg 100% bij niet-behandelde deelnemers en slechts 1,9% bij medicamenteus behandelde patiënten — een opvallend signaal dat reguliere bloeddrukcontrole de werkelijke regulatie onderschat. Per 10% hogere TTR daalde de prevalentie van hersenlaesies met 15% (prevalence ratio 0,85; 95%-BI 0,79-0,91), met sterker effect bij onbehandelde personen. TTR was lager in de winter dan in de zomer. Home BP TTR lijkt een waardevolle aanvulling op spreekuurmetingen voor het inschatten van cerebrovasculaire gezondheid.","abstract_original":"BACKGROUND:Time in target range (TTR) reflects the proportion of time that blood pressure (BP) stays within guideline-recommended levels. However, the distribution of home BP TTR and its association with subclinical cerebrovascular disease in community-based populations remain unclear.METHODS:We investigated annual and seasonal TTR of Internet of Things-based home BP and its association with brain lesions on magnetic resonance imaging in a community-based cohort. Home BP was measured twice daily (morning and evening). Weekly mean BP was calculated from ≥3 valid daily readings, and TTR was defined in those with ≥2 valid weeks/season as the percentage of weeks meeting guideline-based targets (systolic and diastolic BP <135 and <85 mm Hg, respectively, for participants not receiving antihypertensive medication; <125 and <75 mm Hg, respectively, for those receiving medication). Brain lesions included ≥1 magnetic resonance imaging-detected lacunar infarct, white matter hyperintensities, cerebral microbleeds, or intracranial artery stenosis.RESULTS:Among 306 participants (mean age, 56 years; 57% women), median annual TTR was 100% (interquartile range, 92.6%–100%) in participants not receiving antihypertensive medication and 1.9% (0%–19.2%) in those receiving medication. TTR tended to be lower in winter than in summer. In Poisson regression with robust variance, adjusted for demographic, lifestyle, and clinical factors, higher TTR was associated with a lower prevalence of brain lesions (prevalence ratio per 10% higher, 0.85 [95% CI, 0.79–0.91]). The association was stronger among participants not receiving antihypertensive medication (interactionP=0.047), with no heterogeneity across seasons (interactionP=0.958).CONCLUSIONS:Home BP TTR may help characterize longitudinal BP control and provide complementary information regarding cerebrovascular health."}