Home BP monitoring can improve hypertension control
MedWire News: Patients with hypertension can improve their blood pressure (BP) control through home monitoring, meta-analysis results suggest.
"However, simply monitoring home BP is of little value if the patients or their physicians do not act on the results," remark Rajiv Agarwal (Indiana University, Indianapolis, USA) and co-authors.
They report that the efficacy of such monitoring can be improved further if accompanied by "telemonitoring, in which BP readings obtained at home are relayed to the provider who can take appropriate action."
The 37-study meta-analysis, involving 9446 patients with hypertension, showed that home BP monitoring reduced mean systolic and diastolic BP levels by 2.63 and 1.68 mmHg more, respectively, than clinic-based monitoring.
Writing in the journal Hypertension, the team reports that the BP lowering effects of home monitoring were further augmented by the addition of telemonitoring.
Analysis of other effects of home monitoring revealed that twice as many appropriate reductions in antihypertensive medication doses occurred with home monitoring compared with clinic monitoring.
And therapeutic inertia, defined as no medication change despite high BP, was 18% less common among home- than clinic-monitored patients.
Editorialists Giuseppe Mancia and Gianfranco Parati, from University of Milano-Bicocca in Milan, Italy, explained that "including home BP management of treated hypertensive patients favors the therapeutic effect in several ways, ie, through an improvement of compliance to treatment, an avoidance of overtreatment, and a reduction of clinical inertia."
Mancia and Parati conclude that "it will be important to more extensively study different clinical conditions to see whether these advantages are different in relation to factors, such as a patient's motivation to treatment."
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By Lauretta Ihonor