What is the clinical evidence from this study?

Study design: RCT. Population: Hypertension (n=1182). Intervention: Self-monitored blood pressure vs. Usual care (clinic blood pressure). Primary outcome: Clinic measured systolic blood pressure at 12 months (MD -3.5, 95% CI -5.8 to -1.2).

What question did this study set out to answer?

To evaluate the efficacy of self-monitored blood pressure, with or without telemonitoring, compared with usual clinic care for guiding antihypertensive medication titration in primary care.

February 27, 2018The LancetOpen Access

Efficacy of self-monitored blood pressure, with or without telemonitoring, for titration of antihypertensive medication (TASMINH4): an unmasked randomised controlled trial

View Full Paper

Ask AI

Bookmark

Key result

Self-monitoring of blood pressure alone or with telemonitoring significantly lowered systolic blood pressure at 12 months compared to usual care (MD -3.5 mm Hg and -4.7 mm Hg, respectively).

Why the study?

Does self-monitoring of blood pressure, with or without telemonitoring, reduce clinic measured systolic blood pressure in hypertensive patients compared to usual care?

Population

1,182 hypertensive patients older than 35 years with blood pressure higher than 140/90 mm Hg, willing to…

Comparison

Self-monitoring of blood pressure, with or… vs Usual care.

Design

RCT, 1:1:1 randomisation by a secure web-based system., Unmasked.

Follow-up

12 months

Authors

RMRichard J. McManusGeneral / Preventive / Lipids JMJonathan MantPreventive Cardiology MFMarloes FranssenNuffield Orthopaedic Centre

Discussion

Member takes

Implication

Supports self-monitoring integration into primary care hypertension management; confirms telemonitoring efficacy in RCTs.

Key Points

To evaluate the efficacy of self-monitored blood pressure, with or without telemonitoring, compared with usual clinic care for guiding antihypertensive medication titration in primary care.
Unmasked, parallel randomized controlled trial conducted across 142 general practices in the UK (ISRCTN 83571366).
Randomly assigned 1182 adults aged >35 years with blood pressure >140/90 mm Hg (1:1:1) to self-monitoring alone (n=395), self-monitoring with telemonitoring (n=393), or usual clinic care (n=394).
Primary outcome was clinic-measured systolic blood pressure at 12 months, assessed in 1003 available cases.
At 12 months, systolic blood pressure was 137.0 mm Hg (SD 16.7) with self-monitoring and 136.0 mm Hg (SD 16.1) with telemonitoring, compared with 140.4 mm Hg (SD 16.5) under usual care.
Both self-monitoring alone (adjusted mean difference -3.5 mm Hg, 95% CI -5.8 to -1.2) and with telemonitoring (adjusted mean difference -4.7 mm Hg, 95% CI -7.0 to -2.4) significantly lowered systolic blood pressure versus usual care.
No significant difference was detected between self-monitoring with versus without telemonitoring (adjusted mean difference -1.2 mm Hg, 95% CI -3.5 to 1.2), and adverse event rates were similar across all three groups.

Study Design

Type

RCT (n=1,182)

Blinding

Unmasked

Randomization

1:1:1

Multicenter

Yes

Structured PICO

Does self-monitoring of blood pressure, with or without telemonitoring, reduce clinic measured systolic blood pressure in hypertensive patients compared to usual care?

Population

1,182 hypertensive patients older than 35 years with blood pressure >140/90 mm Hg, followed for 12 months.

Intervention

Self-monitoring of blood pressure, with or without telemonitoring, used by general practitioners to titrate antihypertensive medication.

Comparator

Usual care (titration guided by clinic blood pressure readings).

Outcome

Clinic measured systolic blood pressure at 12 months from randomisation.surrogate

Main Result

Mean Difference: -3.5 (95% CI -5.8–-1.2)

Absolute Event Rate: 137% vs 140.4%

Self-monitoring of blood pressure, with or without telemonitoring, significantly improves systolic blood pressure control compared to usual clinic-based care in primary care patients with hypertension.

Cite This Study

McManus et al. (2018) conducted an RCT in Hypertension (n=1,182). Self-monitored blood pressure vs. Usual care (clinic blood pressure) was evaluated on Clinic measured systolic blood pressure at 12 months (MD -3.5, 95% CI -5.8 to -1.2). Self-monitoring of blood pressure alone or with telemonitoring significantly lowered systolic blood pressure at 12 months compared to usual care (MD -3.5 mm Hg and -4.7 mm Hg, respectively).

synapsesocial.com/papers/6a7db3eb1ec832c82ccdab31 https://doi.org/10.1016/s0140-6736(18)30309-x

Topics

Hypertension management

View Full Paper

Ask AI

Bookmark

February 27, 2018The LancetOpen Access

Efficacy of self-monitored blood pressure, with or without telemonitoring, for titration of antihypertensive medication (TASMINH4): an unmasked randomised controlled trial

View Full Paper

Ask AI

Bookmark

Key result

Self-monitoring of blood pressure alone or with telemonitoring significantly lowered systolic blood pressure at 12 months compared to usual care (MD -3.5 mm Hg and -4.7 mm Hg, respectively).

Why the study?

Does self-monitoring of blood pressure, with or without telemonitoring, reduce clinic measured systolic blood pressure in hypertensive patients compared to usual care?

Population

1,182 hypertensive patients older than 35 years with blood pressure higher than 140/90 mm Hg, willing to…

Comparison

Self-monitoring of blood pressure, with or… vs Usual care.

Design

RCT, 1:1:1 randomisation by a secure web-based system., Unmasked.

Follow-up

12 months

Authors

RMRichard J. McManusGeneral / Preventive / Lipids JMJonathan MantPreventive Cardiology MFMarloes FranssenNuffield Orthopaedic Centre

Discussion

Member takes

Implication

Supports self-monitoring integration into primary care hypertension management; confirms telemonitoring efficacy in RCTs.

Key Points

To evaluate the efficacy of self-monitored blood pressure, with or without telemonitoring, compared with usual clinic care for guiding antihypertensive medication titration in primary care.
Unmasked, parallel randomized controlled trial conducted across 142 general practices in the UK (ISRCTN 83571366).
Randomly assigned 1182 adults aged >35 years with blood pressure >140/90 mm Hg (1:1:1) to self-monitoring alone (n=395), self-monitoring with telemonitoring (n=393), or usual clinic care (n=394).
Primary outcome was clinic-measured systolic blood pressure at 12 months, assessed in 1003 available cases.
At 12 months, systolic blood pressure was 137.0 mm Hg (SD 16.7) with self-monitoring and 136.0 mm Hg (SD 16.1) with telemonitoring, compared with 140.4 mm Hg (SD 16.5) under usual care.
Both self-monitoring alone (adjusted mean difference -3.5 mm Hg, 95% CI -5.8 to -1.2) and with telemonitoring (adjusted mean difference -4.7 mm Hg, 95% CI -7.0 to -2.4) significantly lowered systolic blood pressure versus usual care.
No significant difference was detected between self-monitoring with versus without telemonitoring (adjusted mean difference -1.2 mm Hg, 95% CI -3.5 to 1.2), and adverse event rates were similar across all three groups.

Study Design

Type

RCT (n=1,182)

Blinding

Unmasked

Randomization

1:1:1

Multicenter

Yes

Structured PICO

Does self-monitoring of blood pressure, with or without telemonitoring, reduce clinic measured systolic blood pressure in hypertensive patients compared to usual care?

Population

1,182 hypertensive patients older than 35 years with blood pressure >140/90 mm Hg, followed for 12 months.

Intervention

Self-monitoring of blood pressure, with or without telemonitoring, used by general practitioners to titrate antihypertensive medication.

Comparator

Usual care (titration guided by clinic blood pressure readings).

Outcome

Clinic measured systolic blood pressure at 12 months from randomisation.surrogate

Main Result

Mean Difference: -3.5 (95% CI -5.8–-1.2)

Absolute Event Rate: 137% vs 140.4%

Cite This Study

synapsesocial.com/papers/6a7db3eb1ec832c82ccdab31 https://doi.org/10.1016/s0140-6736(18)30309-x

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

Topics

Hypertension management

View Full Paper

Ask AI

Bookmark