Self-Monitoring of BP Reduces Hypertension and Stroke Risk

Patients at risk for hypertension and stroke that self-monitor and make adjustments to medication from home could reduce their risk of stroke by 30% and significantly lower their blood pressure after 12 months, according to a recent study.

For the trial, researchers followed 552 participants exhibiting high blood pressure (at least 130/80 mm) and a pre-existing condition, such as cardiovascular disease, diabetes, chronic kidney disease, and high blood pressure. The mean age of participants was 70 years.
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At the beginning of the study, participants followed a customized management plan that allowed them to request more medication directly from their doctors and take blood pressure readings 2 times every morning for the first week of every month.

After a 12-month period, the results showed a 9.2/3.4 mmHg reduction in blood pressure levels for those who self-monitored compared to those who consulted with their doctors for blood pressure monitoring.

Experts noted that the findings reported in the clinical trial help physicians and healthcare providers gain new knowledge about the safety of efficiency of self-monitoring and self-requesting new medications without a consultant’s supervision.

“Controlling blood pressure is a key target in reducing heart disease and strokes. We have shown that people can measure their own blood pressure, adjust their own medication and achieve better results than standard care without an increase in adverse events. This is possible even for people with previous strokes, heart attacks, diabetes and kidney disease,” said Richard McManus, PhD, the lead author of the study and professor in the Nuffield Department of Primary Care Health Sciences at the University of Oxford.

“Blood pressure monitors are now widely available, costing as little as £15 ($25), and our oldest patient was 88, so self-management is possible for people of all ages,” he said.

The complete study is published in the August issue of the Journal of American Medical Association.

-Michelle Canales

References:

McManus RJ, Mant J, Haque MS, et al. Effect of self-monitoring and medication self-titration on systolic blood pressure in hypertensive patients at high risk of cardiovascular disease. JAMA. 2014 August [epub ahead of print] doi: 10.1001/jama.2014.10057.

Nilsson PM, Nystrom FH. Self-titration of antihypertensive therapy in high-risk patients. JAMA. 2014 August [epub ahead of print] doi: 10.1001/jama.2014.10058.

Oxford University Nuffield Department of Primary Care Health Sciences. Self-managing hypertension can reduce blood pressure for high-risk patients. August 27, 2014. www.phc.ox.ac.uk/news/self-managing-hypertension-can-reduce-blood-pressure-for-high-risk-patients#. Accessed August 27, 2014.