Home Monitoring Improves
Blood Pressure Control

People with high blood pressure do better when they monitor their blood pressure at home, a UK study shows. Home monitoring is linked to a greater number of people achieving target blood pressure, compared with those monitored in the usual way in their doctor's office.

Professor Francesco Cappuccio, from St George's Hospital Medical School, London, UK, and colleagues analyzed 18 randomised controlled trials involving a total of 1359 patients who monitored their pressure at home, and 1355 whose blood pressure was monitored in the healthcare system.

Their results are reported in the British Medical Journal, and are also being presented at the European Society of Hypertension meeting in Paris on 16th June.

The TEAM found that systolic (upper reading) and diastolic (lower reading) pressure were both lower in people who had home blood pressure monitoring. After factoring in various adjustments, systolic and diastolic pressures were about 2 points lower.

The likelihood of having blood pressure above predetermined targets was also lower when people measured their blood pressure at home, the researchers add.

The difference "is not due to the fact that when you go out of the clinic you relax and your blood pressure is lower," Cappuccio told Reuters Health, referring to the so-called "white coat effect."

That's because the trials were designed such that, while people either monitored their blood pressure at home or in the clinic, the final readings for both groups were taken in the clinic.

Cappuccio said, "It is the procedure of taking care of your blood pressure throughout the trial that has led to the blood pressure being lowered when you get to the clinic."

In clinical terms, the differences in blood pressure are quite small, the authors point out in the journal. But considering the millions of people with high blood pressure, those differences "would add up to many, many more strokes and heart attacks as a saving," Cappuccio pointed out.

It isn't clear why home monitoring makes this difference, he noted, although increased awareness of blood pressure probably makes people more likely to engage in healthy lifestyle "and so on."

Regardless, he said, because home blood pressure monitoring is now feasible, acceptable and generally reliable, it's a useful way to involve people more closely in the management of their blood pressure.

SOURCE: British Medical Journal online first, June 11, 2004: http://www.bmj.com.

Reference Source 89

For more information on how to prevent other diseases, use
PreventDisease.com's "Quick Prevention Resources".