Does self-measured blood pressure and lowering systolic blood pressure to <130 mm Hg improve cardiovascular outcomes in adults with high blood pressure?
Lowering systolic blood pressure to <130 mm Hg reduces cardiovascular events, and thiazides remain an optimal first-line therapy.
Our results suggest that: 1) There is a modest but significant improvement in systolic BP in randomized controlled trials of self-measured BP versus usual care at 6 but not 12 months, and for selected patients and their providers self-measured BP may be a helpful adjunct to routine office care. 2) systolic BP lowering to a target of <130 mm Hg may reduce the risk of several important outcomes including risk of myocardial infarction, stroke, heart failure, and major cardiovascular events. No class of medications (ie, angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, calcium channel blockers, or beta blockers) was significantly better than thiazides and thiazide-like diuretics as a first-line therapy for any outcome.
Reboussin et al. (2017) studied this question.