Self-Monitoring Blood Pressure Appears to Improve Results, Study Finds
Patients engaged in their health care do better, expert says
Tuesday, August 6, 2013
And if you have a clinician's help in monitoring your blood pressure, you'll likely do even better, at least in the short term, according to the study, which was published Aug. 6 in the journal Annals of Internal Medicine.
"For adults with hypertension who are willing and able to monitor their blood pressure at home in conjunction with their health care center, self-monitored blood pressure can be a useful tool to lower blood pressure, and possibly lower the risk of cardiovascular events, at least for the short term," said lead researcher Dr. Ethan Balk, from the Institute for Clinical Research and Health Policy Studies at Tufts Medical Center in Boston.
Whether the benefits extend beyond one year needs further research, said Balk, whose team looked at more than 50 studies on the effectiveness of home blood pressure monitoring.
Self-monitoring includes keeping a record of the readings so a physician can determine if your blood pressure medicine is working effectively or needs tweaking. Left uncontrolled, high blood pressure can lead to stroke, eye and kidney damage, heart disease and disability.
Exactly how home monitoring keeps blood pressure levels low isn't clear, Balk said. "Likely reasons are improved monitoring and tailored treatment of blood pressure by both the clinician or nursing staff and the patient, and increased incentives to control one's diet and increase physical activity," he said. "But these explanations are purely conjectural."
Also, it isn't clear to what degree additional support enhances the benefits or which methods of additional support are best, Balk said.
"An important caveat is that the evidence refers to self-monitored blood pressure used in conjunction with clinicians and/or nurses who are using and monitoring the information," he said.
The results don't apply to people who decide on their own to measure their blood pressure at home without consulting medical professionals, he said.
The findings support current health care guidelines, said Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, and a spokesman for the American Heart Association.
"National and international guidelines, including those from the American Heart Association, recommend that patients with hypertension measure and monitor their blood pressure in the home setting, and a number of studies have shown this can result in better blood pressure control," he said.
"These findings ... highlight the importance of actively engaging patients in the measuring, monitoring, goal achievement and goal maintenance of their blood pressure," he said.
Blood-pressure-monitoring devices available in drugstores and other shops range in price from $30 to more than $100.
When choosing a device, the American Heart Association recommends an automatic, cuff-style, upper-arm monitor. Wrist and finger monitors are not recommended because they yield less reliable readings. Monitors for the elderly or pregnant women should be validated specifically for those purposes.
For the current report, Balk's team reviewed 52 published studies in which patients monitored their blood pressure with and without assistance. Such help ranged from educational materials to contact with a nurse or pharmacist or counseling over the telephone.
They found some evidence that monitoring blood pressure at home improved control at six months, but not at 12 months.
When patients got help, either through educational material or direct contact with medical professionals, home monitoring improved blood pressure control at both six and 12 months.
From this data, Balk's group concluded that home blood pressure monitoring is effective in the short term.
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