A large-scale, cross-sectional study incorporating data from various countries around the world, including both low-and high-income subjects, showed that the prevalence of hypertension (HTN) was 40.8% in 142 042 participants, but only 46.5% were aware of the diagnosis criteria, and 32.5% had controlled blood pressure (BP), despite the high rate (87.5%) of pharmaceutical treatment. 1 Low BP control could be attributed to poor medication adherence and patients' ignorance on the importance of HTN, as well as therapeutic inertia by physicians. To overcome this, many approaches have been attempted including self-blood pressure monitoring (SBPM). However, this has demonstrated mixed results on HTN control. 2-5 Some meta-analyses including small-sized studies have also shown inconsistent results. 2,5 These conflicting data may partly be attributed to the diversity of socio-economic levels and racial differences of the participants and combined other interventions on top of SBPM as well as small sample size.We performed this nationwide large-scale prospective observational study involving general hospitals and local clinics to examine
AbstractWe investigated whether self-blood pressure monitoring (SBPM) can improve the control rate of blood pressure (BP), adherence of antihypertensive medications, and the awareness of the importance of BP control in hypertensive patients. A total of 7751 patients who visited the outpatient clinics of private and university hospitals in Korea were given automatic electronic BP monitors and were recommended to measure their BP daily at home for 3 months. Changes in office BP, attainment of target BP, adherence to taking antihypertensive drugs, and awareness of BP were compared before and after SBPM. Patients and physicians were surveyed on their perception of BP and SBPM. Mean BP significantly decreased from 142/88 to 129/80 mm Hg (P < .001), and attainment of the target BP increased from 32% to 59% (P < .001) after SBPM. Drug non-adherence, which was defined as patient's not taking medication days per week, decreased significantly from 0.86 days to 0.53 days (P < .001).The rate of awareness of the BP goal increased from 57% to 81% (P < .001). Patients estimated that their mean BP was 125/81 mm Hg, but their actual mean BP was 142/88 mm Hg. Awareness about the importance of SBPM increased from 90% to 98%. The rate of SBPM ≥ once per week further increased, from 34% to 96%. In conclusion, SBPM is associated with reduced BP, better BP control rate, greater drug adherence, and improved perception of BP by the patients.