Factors Associated With Physician Recommendation of Home Blood Pressure Monitoring and Blood Pressure in the US Population.

BACKGROUND: Hypertension guidelines recommend home blood pressure monitoring (HBPM) to help achieve blood pressure (BP) control. We hypothesized that HBPM use with a physician recommendation would be associated with lower BP and greater medication adherence.
METHODS: We used data from 6,320 adults with hypertension in the National Health and Nutrition Examination Survey 2009-2014 to characterize the association of (i) provider recommendation for HBPM and (ii) HBPM use on 2 outcomes: measured BP (linear regression) and medication adherence (logistic regression). Provider recommendation, HBPM use, and medication use were self-reported.
RESULTS: Among adults with hypertension, 30.1% reported a physician recommendation for HBPM, among whom 82.0% reported using HBPM. Among those who did not report a physician recommendation for HBPM, 28.3% used HBPM. Factors associated with a physician recommendation were having health insurance, higher education attainment, hypertension awareness, and having a prescription for antihypertensive medication. Among those who reported receiving a physician recommendation, those who used HBPM had a mean BP that was 3.1/4.5 mm Hg lower than those who did not. Those who reported having a physician recommendation and using HBPM were more likely to report hypertension medication adherence (odds ratio 2.9; 95% confidence interval: 2.0, 4.4).
CONCLUSIONS: HBPM use was associated with lower BP and higher medication adherence. Use of HBPM was higher among those with a physician recommendation. These results support a role for physicians in counseling and partnering with patients on HBPM use for BP management. © American Journal of Hypertension, Ltd 2020. All rights reserved. For Permissions, please email: journals.permissions@oup.com.