BACKGROUND: The measurement of blood pressure (BP) at home by patients with hypertension is increasingly used to assess and monitor BP. Evidence for its effectiveness in improving BP control is mixed. METHODS: To determine if home BP monitoring improves BP a pragmatic cluster randomized contolled trial was carried out in family practices in southeastern Ontario, Canada. Family practice patients with uncontrolled hypertension were recruited to the trail. Patients were divided into two groups: one with at least weekly measurements of BP at home, recording those measurements and showing those to the family physician during office visits for hypertension and the control group were given usual care. The primary outcome was mean awake BP on ambulatory monitoring at 6- and 12-month follow-up and the secondary outcomes were mean BP on full 24-hour ambulatory blood pressure monitoring (ABPM), mean sleep BP on ABPM and BP on the BpTRU device, all at 6- and 12-month follow-up. RESULTS: Home BP monitoring did not improve BP compared to usual care at 12-month follow-up: mean awake systolic BP on ABPM [141.1 versus 142.8 mmHg, mean difference 1.7 mmHg; 95% confidence interval (CI) -0.6 to 4.0, P = 0.314] and mean awake diastolic BP on ABPM (78.7 versus 79.4 mmHg, mean difference 0.7 mmHg; 95% CI -7.7 to 9.1, P = 0.398). Similar negative results were obtained for men and women separately. However, outcomes using the full 24-hour ABPM and the BpTRU device showed a significantly lower diastolic BP at 12 months. When analysis was done by sex, this effect was shown to be only in men. CONCLUSION: Home BP monitoring may improve BP control in men with hypertension.
RCT Entities:
BACKGROUND: The measurement of blood pressure (BP) at home by patients with hypertension is increasingly used to assess and monitor BP. Evidence for its effectiveness in improving BP control is mixed. METHODS: To determine if home BP monitoring improves BP a pragmatic cluster randomized contolled trial was carried out in family practices in southeastern Ontario, Canada. Family practice patients with uncontrolled hypertension were recruited to the trail. Patients were divided into two groups: one with at least weekly measurements of BP at home, recording those measurements and showing those to the family physician during office visits for hypertension and the control group were given usual care. The primary outcome was mean awake BP on ambulatory monitoring at 6- and 12-month follow-up and the secondary outcomes were mean BP on full 24-hour ambulatory blood pressure monitoring (ABPM), mean sleep BP on ABPM and BP on the BpTRU device, all at 6- and 12-month follow-up. RESULTS: Home BP monitoring did not improve BP compared to usual care at 12-month follow-up: mean awake systolic BP on ABPM [141.1 versus 142.8 mmHg, mean difference 1.7 mmHg; 95% confidence interval (CI) -0.6 to 4.0, P = 0.314] and mean awake diastolic BP on ABPM (78.7 versus 79.4 mmHg, mean difference 0.7 mmHg; 95% CI -7.7 to 9.1, P = 0.398). Similar negative results were obtained for men and women separately. However, outcomes using the full 24-hour ABPM and the BpTRU device showed a significantly lower diastolic BP at 12 months. When analysis was done by sex, this effect was shown to be only in men. CONCLUSION: Home BP monitoring may improve BP control in men with hypertension.
Authors: Holly J Kramer; Raymond R Townsend; Karen Griffin; Joseph T Flynn; Daniel E Weiner; Michael V Rocco; Michael J Choi; Matthew R Weir; Tara I Chang; Rajiv Agarwal; Srinivasan Beddhu Journal: Am J Kidney Dis Date: 2019-04 Impact factor: 8.860
Authors: Katherine L Tucker; James P Sheppard; Richard Stevens; Hayden B Bosworth; Alfred Bove; Emma P Bray; Kenneth Earle; Johnson George; Marshall Godwin; Beverly B Green; Paul Hebert; F D Richard Hobbs; Ilkka Kantola; Sally M Kerry; Alfonso Leiva; David J Magid; Jonathan Mant; Karen L Margolis; Brian McKinstry; Mary Ann McLaughlin; Stefano Omboni; Olugbenga Ogedegbe; Gianfranco Parati; Nashat Qamar; Bahman P Tabaei; Juha Varis; Willem J Verberk; Bonnie J Wakefield; Richard J McManus Journal: PLoS Med Date: 2017-09-19 Impact factor: 11.069
Authors: J P Sheppard; K L Tucker; W J Davison; R Stevens; W Aekplakorn; H B Bosworth; A Bove; K Earle; M Godwin; B B Green; P Hebert; C Heneghan; N Hill; F D R Hobbs; I Kantola; S M Kerry; A Leiva; D J Magid; J Mant; K L Margolis; B McKinstry; M A McLaughlin; K McNamara; S Omboni; O Ogedegbe; G Parati; J Varis; W J Verberk; B J Wakefield; R J McManus Journal: Am J Hypertens Date: 2020-03-13 Impact factor: 2.689
Authors: Glessiane de Oliveira Almeida; Felipe J Aidar; Dihogo Gama de Matos; Paulo Francisco de Almeida-Neto; Enaldo Vieira de Melo; José Augusto Soares Barreto Filho; Marcos Antonio Almeida-Santos; Victor Batista Oliveira; Rebeca Rocha de Almeida; Suelen Maiara Dos Santos; Larissa Monteiro Costa Pereira; Juliana Santos Barbosa; Antônio Carlos Sobral Sousa Journal: Medicina (Kaunas) Date: 2021-01-17 Impact factor: 2.430