P151 Recommendations for Home Blood Pressure Measurement Are Inconsistent Between International Guidelines

Background and objective. Recommendations made across blood pressure (BP) guidelines should use consistent messaging to inform patient education for home BP measurement. It is not known if recommendations for home BP measurement are consistent across BP guidelines, which was the aim of this study. Methods. Recommendations for home BP measurement were extracted verbatim from six BP guidelines and expert consensus statements (Australian, United States, Canadian, European, International and Japanese). Consistency between BP guidelines was assessed by head-to-head comparison of recommendations and classified as inconsistent if the recommendation was not differed from one or more other recommendation. Analysis was conducted independently by two investigators (EC, KS) and conflicts adjudicated by two other investigators (NC, DP). Results. In total, 101 recommendations for home BP measurement were identified, and each guideline contained a median of 33 recommendations. Forty-four recommendations (44%) were present in two or more of the six guidelines. The only recommendation made by all six guidelines was to measure BP in a seated position. Forty-nine recommendations (49%) were inconsistent with at least one other recommendation. Twenty-nine of these recommendations (59%) contained a time parameter such as how many days to measure BP at home and how long to abstain from caffeine or tobacco usage prior to measurement. All recommendations on choosing and fitting a BP cuff were inconsistent, except the recommendations to fit the cuff to a bare arm and choose an appropriately sized cuff. Conclusion. There is a lack of consistency in the recommendations made for home BP measurement by international guidelines. Harmonisation across BP guidelines is needed to create clear, unambiguous messaging in guideline recommendations to support implementation of evidence-based care for home BP measurement and management.