Does self-measurement of blood pressure at home reduce blood pressure levels in patients compared to usual care?
Home blood pressure measurement, particularly when using upper-arm cuffs and combined with telemonitoring, significantly reduces systolic and diastolic blood pressure compared to usual care.
The effect of self-measurement of blood pressure (BP) at home (home BP measurement, HBPM) has been evaluated over the past decade. This meta-analysis included the latest studies to determine whether HBPM reduced BP (PROSPERO ID: CRD42023442225). PubMed, Cochrane Library Database, and IchuShi-Web were searched for randomized controlled trials after the year 2000 which demonstrated the effect of HBPM on BP change compared with usual care (UC). Overall, 65 articles (n = 21,053; 63 based on patients with hypertension) were included. The systolic/diastolic BP reduction was significantly greater in the HBPM than in the UC group by 3.27/1.61 mmHg (95% confidence intervals: 2.40-4.15/1.14-2.07) at the end of the intervention, and I2 values ≥ 46.7% suggested moderate-to-high heterogeneity. The funnel plots exhibited no notable publication bias (Egger's test p ≥ 0.16). HBPM with co-interventions (such as telemonitoring) showed a stronger BP-lowering effect than without co-interventions while the effect of HBPM on BP change remained significant in the absence of co-interventions. HBPM was not associated with systolic BP changes when we combined the four studies that used a wrist cuff device for HBPM. The number of antihypertensive medications increased by 0.17 medications in the HBPM group compared with that in the UC group. There were no significant differences in body mass index changes or risk of severe adverse outcomes between the groups. Our results demonstrated a beneficial effect of HBPM in reducing BP, particularly when used in conjunction with telemonitoring or additional medical support and when employing upper-arm cuff devices.
Satoh et al. (Thu,) studied this question.