Home Blood Pressure Monitoring (HBPM): The way forward for Sri Lanka; a review article

Hypertension is a major preventable cause of cardiovascular and kidney related morbidity and mortality. It affects one third of the Sri Lankan population and is the single leading cause of death annually. Home blood pressure monitoring (HBPM) gained interest compared to office BP measurement (OBPM) after several studies demonstrated its superior prognostic value in predicting cardiovascular risk. White coat uncontrolled hypertension (WUCH) and masked uncontrolled hypertension (MUCH) may be overlooked in office BP measurement. Both of these phenomena are correctly identified in HBPM. Behavioural modification, patient involvement and initiation of antihypertensive medications at the right point are important in the management of hypertension. HBPM allows healthcare providers to make behavioural and pharmacological modification at the crucial point, because of the accuracy in BP measurement. Further it reduces health expenditure in the long run by reducing outpatient clinic visits and preventing adverse cardiovascular and kidney related outcomes. Given the challenges posed by the pandemic, HBPM is a better option in managing hypertension with the help of technology and telehealth. However further studies are needed on HBPM in Sri Lanka to analyse the efficacy in our own context.