Study Offers More Support for Blood Pressure Self-Monitoring

By Amy Orciari Herman

Edited by Susan Sadoughi, MD, and Richard Saitz, MD, MPH, FACP, DFASAM

Self-monitoring of blood pressure, with or without telemonitoring, can lead to significant reductions in systolic BP, finds a Lancet study.

Nearly 1200 hypertensive adults with BP not controlled below 140/90 mm Hg despite antihypertensive medications were randomized to one of three groups: clinic BP measurement alone (usual care), self-monitoring alone, or self-monitoring with telemonitoring. With self-monitoring, participants measured their BP with an automated electronic sphygmomanometer at home, twice in the morning and at night, during the first week of each month, and their clinicians made treatment adjustments based on these measurements. The self-monitoring-alone group mailed their measurements to their clinicians, while the telemonitoring group sent their readings through a text-based service.

At 12 months, mean systolic BP was significantly lower with self-monitoring alone (137 mm Hg) and self-monitoring plus telemonitoring (136 mm Hg) than with usual care; the difference between the two self-monitoring groups was not significant. The self-monitoring groups received slightly, albeit significantly, more BP medications than the usual-care group.

The researchers note that the BP reductions with self-monitoring "would be expected to result in around a 20% reduction in stroke risk and 10% reduction in coronary heart disease risk." Editorialists write, "Surely, it is time for care providers to rethink the chain of medical decision taking in hypertension management? Should not the driver's seat be co-chaired by health literate patients and dedicated professionals from allied fields?"