Home blood pressure monitoring: methodology, clinical relevance and practical application: a 2021 position paper by the Working Group on Blood Pressure Monitoring and Cardiovascular Variability of the European Society of Hypertension

Parati, Gianfranco; Stergiou, George S.; Bilo, Grzegorz; Κόλλιας, Αναστάσιος; Pengo, Martino; Ochoa, Juan Eugenio; Agarwal, Rajiv; Asayama, Kei; Asmar, Roland; Burnier, Michel; Sierra, Alejandro de la; Giannattasio, Cristina; Gosse, Philippe; Head, Geoffrey A.; Hoshide, Satoshi; Imai, Yutaka; Kario, Kazuomi; Li, Yan; Manios, Efstathios; Mant, Jonathan; McManus, Richard J; Mengden, Thomas; Mihailidou, Anastasia S.; Muntner, Paul; Myers, Martin G.; Niiranen, Teemu J.; Ntineri, Angeliki; O’Brien, Eoin; Octavio, José; Ohkubo, Takayoshi; Omboni, Stefano; Padfield, P. L.; Palatini, Paolo; Pellegrini, Dario; Postel-Vinay, Nicolas; Ramiréz, Agustín J.; Sharman, James E.; Shennan, Andrew; Silva, Eglé; Topouchian, Jirar; Torlasco, Camilla; Wang, Tzung‐Dau; Weber, Michael A.; Whelton, Paul K.; White, William Β.; Mancia, Giuseppe

doi:10.1097/hjh.0000000000002922

Cited by 108 publications

(140 citation statements)

References 286 publications

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“…It should be further noted that this study was conducted in accordance with the 2010 ESH guidelines for HBPM [ 13 ] before the implementation of the 2021 ESH guidelines [ 16 ]. However, the assessment of patient techniques for errors and the measurement techniques of the researchers were conducted in a manner also consistent with the new guidelines.…”

Section: Discussionmentioning

confidence: 99%

The quality of patients’ self-blood pressure measurements: a cross-sectional study

Nessler

Krztoń-Królewiecka

Suska

et al. 2021

BMC Cardiovasc Disord

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Background The accurate and independent measurement of blood pressure (BP) by patients is essential for home BP monitoring (HBPM) and determining the quality of hypertension (HTN) control. This study aimed to evaluate the BP self-measurement techniques of hypertensive patients and their accuracy in accordance with established guidelines. We sought to identify the common errors that patients make and suggest improvements that can be implemented in the primary healthcare setting to increase the reliability of HBPM conducted by hypertensive patients. Methods One hundred patients diagnosed with HTN completed a questionnaire inquiring about their health and demographic data and BP monitoring practices. Patients were then observed and filmed while measuring their BP on their own devices in five primary healthcare centres in Kraków, Poland. The correctness of their techniques was assessed in accordance with the European Society of Hypertension guidelines on HBPM. Results Only 3% of patients measured their BP without error; 60% made three or more errors. The most frequent error, made by 76% of subjects, was incorrect sphygmomanometer cuff placement (above or below heart level, or/and the indicator mark was not aligned with the brachial artery). Regarding patients’ previous instruction for the correct use of their devices, 36% of patients referred to their monitor’s user manual, 22% did not receive any prior assistance, and only 29% were adequately counselled by physicians on how to measure their BP correctly. Conclusions Our findings suggest that primary healthcare physicians and their personnel often do not adequately instruct patients on how to measure their BP correctly. Therefore, healthcare systems must provide patients with more adequate training and reference materials on the best practices of BP monitoring.

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Section: Discussionmentioning

confidence: 99%

The quality of patients’ self-blood pressure measurements: a cross-sectional study

Nessler

Krztoń-Królewiecka

Suska

et al. 2021

BMC Cardiovasc Disord

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“…• Dissemination of SMBP monitoring protocols to patients to assure accurate BP measurement in the home (Parati et al, 2021). Trial (Allen et al, 2011), Nurse-Managed BP Telemonitoring Among Urban African Americans (Artinian et al, 2007), and the Self-Help Intervention Program for High Blood Pressure Care (Kim et al, 2011).…”

Section: What This C All To Ac Ti On Me An S For E Viden Ce-ba S Ed Q...mentioning

confidence: 99%

Improving hypertension control and cardiovascular health: An urgent call to action for nursing

Hannan

Commodore‐Mensah

Tokieda

et al. 2022

Worldviews Ev Based Nurs

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Background Hypertension is a leading cause of cardiovascular disease (CVD) and affects nearly one in two adults in the United States when defined as a blood pressure of at least 130/80 mm Hg or on antihypertensive medication (Virani et al., 2021, Circulation, 143, e254). Long‐standing disparities in hypertension awareness, treatment, and control among racial and ethnic populations exist in the United States. High‐quality evidence exists for how to prevent and control hypertension and for the role nurses can play in this effort. In response to the 2020 Surgeon General's Call to Action to Control Hypertension, nursing leaders from 11 national organizations identified the critical roles and actions of nursing in improving hypertension control and cardiovascular health, focusing on evidence‐based nursing interventions and available resources. Aims To develop a unified “Call to Action for Nurses” to improve control of hypertension and cardiovascular health and provide information and resources to execute this call. Methods This paper outlines roles that registered nurses, advanced practice nurses, schools of nursing, professional nursing organizations, quality improvement nurses, and nursing researchers can play to control hypertension and prevent CVD in the United States. It describes evidence‐based interventions to improve cardiovascular health and outlines actions to bring hypertension and CVD to the forefront as a national priority for nursing. Linking Evidence to Action Evidence‐based interventions exist for nurses to lead efforts to prevent and control hypertension, thus preventing much CVD. Nurses can take actions in their communities, their healthcare setting, and their organization to translate these interventions into real‐world practice settings.

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“…As such, the patient should be encouraged by the exercise professional to undertake home BP monitoring to confirm BP level. Home BP monitoring, when performed according to recommendations, can provide complementary information surrounding BP control to that of clinic and ambulatory BP [ 54 , 55 ]. User-friendly resources and instructions on how to accurately perform home BP measurement in a standardised manner are available ( and ) and summarised in Table 2 .…”

Section: Evaluate and Correspondmentioning

confidence: 99%

The Identification and Management of High Blood Pressure Using Exercise Blood Pressure: Current Evidence and Practical Guidance

Schultz

Currie

Hedman

et al. 2022

IJERPH

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High blood pressure (BP) is a leading risk factor for cardiovascular disease (CVD). The identification of high BP is conventionally based on in-clinic (resting) BP measures, performed within primary health care settings. However, many cases of high BP go unrecognised or remain inadequately controlled. Thus, there is a need for complementary settings and methods for BP assessment to identify and control high BP more effectively. Exaggerated exercise BP is associated with increased CVD risk and may be a medium to improve identification and control of high BP because it is suggestive of high BP gone undetected on the basis of standard in-clinic BP measures at rest. This paper provides the evidence to support a pathway to aid identification and control of high BP in clinical exercise settings via the measurement of exercise BP. It is recommended that exercise professionals conducting exercise testing should measure BP at a fixed submaximal exercise workload at moderate intensity (e.g., ~70% age-predicted heart rate maximum, stage 1–2 of a standard Bruce treadmill protocol). If exercise systolic BP is raised (≥170 mmHg), uncontrolled high BP should be assumed and should trigger correspondence with a primary care physician to encourage follow-up care to ascertain true BP control (i.e., home, or ambulatory BP) alongside a hypertension-guided exercise and lifestyle intervention to lower CVD risk related to high BP.

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Home blood pressure monitoring: methodology, clinical relevance and practical application: a 2021 position paper by the Working Group on Blood Pressure Monitoring and Cardiovascular Variability of the European Society of Hypertension

Cited by 108 publications

References 286 publications

The quality of patients’ self-blood pressure measurements: a cross-sectional study

The quality of patients’ self-blood pressure measurements: a cross-sectional study

Improving hypertension control and cardiovascular health: An urgent call to action for nursing

The Identification and Management of High Blood Pressure Using Exercise Blood Pressure: Current Evidence and Practical Guidance

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