BOSTON, MA — Self-measurement of blood pressure in the home, whether or not supplemented with counseling, educational materials, or other kinds of support, lowers BP over six months to a year compared with standard clinic-based BP monitoring, suggests a meta-analysis of 52 prospective studies published August 5, 2013 in the Annals of Internal Medicine.
"Self-measured blood-pressure monitoring lowers BP, but its sustainability and long-term clinical effectiveness remain uncertain," according to the authors, led by Dr Katrin Uhlig (Tufts University Medical Center, Boston, MA). Their findings, they note, apply to patients with uncomplicated hypertension and no recent history of acute illness.
Across the 26 comparisons of self-monitoring alone vs usual care, systolic BP dropped a significant 3.9 mm Hg and diastolic a significant BP 2.4 mm Hg on average at six months; differences weren't significant at 12 months. Thus, the group writes, "moderate-strength evidence supports a lower BP with self–BP monitoring at six months and possibly at 12 months."
In 25 comparisons of self-monitoring plus additional support vs usual care, systolic and diastolic reductions ranged from 3.4 to 8.9 mm Hg and from 1.9 to 4.4 mm Hg, respectively, such that "high-strength evidence supports a lower BP [with the intervention] for up to 12 months."
"The observed magnitudes in BP reductions by [self-BP-monitoring] with or without additional support would be clinically relevant on a population level if they were sustained over time," the group writes. Additional support in the studies included telemonitoring, counseling on medication adherence, behavioral management, and web-based pharmacist counseling.
"Low-strength" evidence from 13 studies comparing self-monitoring plus additional support vs self-monitoring alone "failed to support a difference" between the two strategies.
The study was primarily funded by the Agency for Healthcare Research and Quality. Uhlig has no conflicts of interest. Disclosures for the authors are listed here.
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Cite this: Self-Measured BP Monitoring Can Mean Fewer mm of Hg - Medscape - Aug 08, 2013.