Effects of home blood pressure measurement on long-term BP control.

Abstract

This research reports level of blood pressure control and ability to maintain newly discovered hypertensives in a municipal hospital setting by use of family-and self-monitored home blood pressure units. Three hundred ninety-six patients were randomized into family-and self-monitored blood pressure groups and a control group. Findings indicate that the use of either self-or family-read cuffs is effective in the first six months of treatment in lowering blood pressures. The data are suggestive of a beneficial effect of the IntrodiuctionThe exponential growth in research on hypertension during the last decade results primarily from the recognition that standard medical regimens are effective in reducing the undesirable sequelae of uncontrolled hypertension. 1-3 Two of the major areas of research involve screening programs,4-9 and the problem of maintaining patients on antihypertensive therapy which is part of a broader area regarding the maintenance of behavioral change. [10][11][12] To facilitate compliance and its correlate, blood pressure control, a number of intervention strategies have been tested including locating a hypertension specialty clinic in the community,3 6'320 locating a hypertension treatment clinic in or near the work site, 8,21-23 establishing specialty clinics within university medical clinics,2425 providing intense follow-up for hypertension patients to assure appointment keeping,2627 providing various forms of social support and education,28-32 and providing patients with self-monitoring blood pressure cuffs.33-37 These interventions for improving the control of blood pressure have met with varying levels of success.There is effective in maintaining controlled BP for a time period greater than that required for an initial BP reduction.Three specific hypotheses were tested: I) the use of a home blood pressure cuff administered by a patient-selected significant other (usually a family member identified by the patient) will enhance BP reduction over either a self-administered blood pressure cuff group or a "standard treatment" group; 2) the use of a self-administered blood pressure cuff will enhance blood pressure reduction over a "standard treatment" group; and 3) fewer patients will drop out of treatment from the significant other administered group than from either the self-administered or "standard treatment" groups. MethodsPatients in this project lived in inner-city Indianapolis and were predominantly low income and Black. The study was conducted in the Medicine Clinic of a large, urban, university affilitated municipal hospital. The hospital serves a broad spectrum of the community and also has responsibility for the medical care of the county's indigent population.Patients entered into this study were either newly discovered hypertensive patients or previously treated patients who had been untreated for at least one year. Study patients were identified from screening and referral from a community screening effort9 and from programs both in the community and the hospital outpat...

Impact of Atrial Fibrillation on the Accuracy of Oscillometric Blood Pressure Monitoring

“…19 Moreover, home blood pressure monitoring improves both therapeutic compliance and blood pressure control. 15,20,21 Especially for older patients, oscillometric blood pressure monitors provide several advantages: the measurement procedure is easier than auscultatory sphygmomanometry. Sphygmomanometry requires an accurate detection of the Korotkoff sounds, which may be impaired by hearing-loss in older patients.…”

Home blood-pressure monitoring among hypertensive patients in an Asian population

“…While there was an isolated report 6 that HBPM improved prediction of hypertension-related morbidity and mortality, evidences that HBPM was costeffective, 18 improved BP control 18,19 and compliance with therapy 20 were equivocal or conflicting. Nevertheless, there had been reports indicating benefits in each of the areas.…”

Monitorização residencial da pressão arterial e monitorização ambulatorial da pressão arterial versus medida de pressão arterial no consultório

“…Os resultados deste estudo confirmaram que as médias da MAPA e da MRPA são mais baixas do que as de consultório [14][15][16] . Além disso, a avaliação das médias da MRPA ao longo dos períodos de um dia e dos dias da semana mostrou pequenas variações.…”