Intermittent self-monitoring of blood pressure significantly increased the achievement of home blood pressure targets compared to ordinary treatment (29% vs 16%, P=0.016).
RCT (n=269)
parallel-group
Yes
Does intermittent self-monitoring of blood pressure improve blood pressure control compared to ordinary treatment in hypertensive patients in primary health care?
Intermittent self-monitoring of blood pressure significantly improves systolic blood pressure reduction and target achievement compared to ordinary treatment in primary care.
Absolute Event Rate: 29% vs 16%
p-value: p=0.016
BACKGROUND: The majority of hypertensive patients do not reach the target blood pressure (BP). We sought to clarify whether intermittent self-monitoring of BP leads to better BP control compared to ordinary treatment in general practice. METHODS: Two hundred sixty-nine hypertensive patients participated in this multicenter, randomized, parallel-group study in primary health care. Home BP was measured in the self-monitoring (SM) group at 0, 2, 4, and 6 months, and in the control (C) group at 0 and 6 months. The participating physicians were instructed to intensify the antihypertensive therapy when needed. RESULTS: At the beginning, both groups had similar home BP levels (SM 143.1 +/- 17.4/85.3 +/- 7.4 mm Hg v C 143.9 +/- 18.3/85.4 +/- 7.5 mm Hg). After 6 months, there were significant decreases in systolic (P <or= .0001), diastolic (P <or= .0029), and pulse pressures (P <or= .021) in both groups. Systolic (-7.8 +/- 13.1 mm Hg v -4.5 +/- 12.2 mm Hg, P = .047) and pulse pressure (-4.7 +/- 9.0 mm Hg v -2.2 +/- 10.0 mm Hg, P = .042) decreased significantly more than in the self-monitoring group. The decrease in diastolic pressure was similar in both groups (SM -3.1 +/- 6.2 mm Hg v C -2.3 +/- 8.3 mm Hg, P = not significant). The patients in the SM group reached home BP target more often than those in the C group (29% v 16%, P = .016). There was a nonsignificant trend toward lower office BP values in the SM group. CONCLUSIONS: Self-monitoring decreased systolic and pulse pressure significantly more than ordinary treatment and promoted achievement of target BP. This was most likely due to improved patient compliance and more active treatment by the physicians. Our results suggest that home measurement is useful in the control of hypertension.
Halme et al. (Tue,) conducted a rct in Hypertension (n=269). Intermittent self-monitoring of blood pressure vs. Ordinary treatment was evaluated on Achievement of home blood pressure target (p=0.016). Intermittent self-monitoring of blood pressure significantly increased the achievement of home blood pressure targets compared to ordinary treatment (29% vs 16%, P=0.016).