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home blood pressure monitoring

Indications: - white-coat hypertension [2] - patient participation in managing their own blood pressure [7] Procedure: Rest at least 5 minutes before reading [6] .. or 30 minutes after exercising Wait at least 30 minutes after nicotine use Wait at least 2 hours after caffeine use 3 reading 1 minute apart & average them [6] Clinical significance: - goal: systolic blood pressure < 135 mm Hg [7] - systolic BP goal corresponds with threshold for treatment with antihypertensive agent [7] Notes: Comments from clinical trials 1) blood pressure may be underestimated [1] 2) patients more likely to reach blood pressure goals [4,5] 3) self-monitoring of blood pressure improves systolic BP & may reduce stroke risk [10] 4) self-referral to the emergency department with asymptomatic hypertension from home or pharmacy blood pressure measurement admitted to hospital 3% of time [11]

Related

ambulatory blood pressure monitoring (ABPM) blood pressure (BP) hypertension (HTN, high blood pressure, HBP)

References

  1. Journal Watch 24(7):55, 2004 Staessen JA et al, JAMA 291:955, 2004 PMID: 14982911
  2. Journal Watch 24(8):64, 2004 Bobrie G et al, JAMA 291:1342, 2004 PMID: 15026401
  3. Home Blood Pressure Monitors Prescriber's Letter 11(2):11 2004 Detail-Document#: 200212 (subscription needed) http://www.prescribersletter.com
  4. Journal Watch 24(18):124, 2004 Cappuccio FP, Kerry SM, Forbes L, Donald A. Blood pressure control by home monitoring: meta-analysis of randomised trials. BMJ. 2004 Jul 17;329(7458):145. Epub 2004 Jun 11. Erratum in: BMJ. 2004 Aug 28;329(7464):499. PMID: 15194600 http://bmj.bmjjournals.com/cgi/content/full/329/7458/145
  5. Halme L, et al, Self-monitoring of blood pressure promotes achievement of blood pressure target in primary health care. Am J Hypertension 2005, 18:1415 PMID: 16280273
  6. Prescriber's Letter 15(3): 2008 Blood Pressure Monitoring Detail-Document#: 240304 (subscription needed) http://www.prescribersletter.com
  7. Medical Knowledge Self Assessment Program (MKSAP) 16, 17 American College of Physicians, Philadelphia 2012, 17
  8. Green BB, Cook AJ, Ralston JD et al Effectiveness of home blood pressure monitoring, Web communication, and pharmacist care on hypertension control: a randomized controlled trial. JAMA. 2008 Jun 25;299(24):2857-67 PMID: 18577730
  9. Pickering TG, Miller NH, Ogedegbe G et al Call to action on use and reimbursement for home blood pressure monitoring: executive summary: a joint scientific statement from the American Heart Association, American Society Of Hypertension, and Preventive Cardiovascular Nurses Association. Hypertension. 2008 Jul;52(1):1-9 PMID: 18497371
  10. McManus RJ, Mant J, Franssen M et al Efficacy of self-monitored blood pressure, with or without telemonitoring, for titration of antihypertensive medication (TASMINH4): an unmasked randomised controlled trial. Lancet. Feb 27, 2018 PMID: 28193176 Free PMC Article http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30309-X/fulltext - Rietzschel ER, De Buyzere ML. Hypertension: time for doctors to switch the driver's seat? Lancet. Feb 27, 2018 PMID: 29499874 Free Article http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30317-9/fulltext
  11. Atzema CL, Wong A, Masood S et al. The characteristics and outcomes of patients who make an emergency department visit for hypertension after use of a home or pharmacy blood pressure device. Ann Emerg Med 2018 Jul 18; PMID: 30037583
  12. Picone DS et al. Availability, cost, and consumer ratings of popular nonvalidated vs validated blood pressure-measuring devices sold online in 10 countries. JAMA. 2023;329(17):1514-1516 PMID: 37129661 PMCID: PMC10155061 (available on 2023-11-02) https://jamanetwork.com/journals/jama/fullarticle/2804335