Impact of Self-Monitoring of Blood Pressure on Processes of Hypertension Care and Long-Term Blood Pressure Control

Background Self-monitoring of blood pressure (SMBP) improves blood pressure (BP) outcomes at 12-months, but information is lacking on how SMBP affects hypertension care processes and longer-term BP outcomes. Methods and Results We pooled individual participant data from 4 randomized clinical trials...

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Veröffentlicht in:Journal of the American Heart Association 2020-08, Vol.9 (15), p.e016174-e016174
Hauptverfasser: Bryant, Kelsey B, Sheppard, James P, Ruiz-Negrón, Natalia, Kronish, Ian M, Fontil, Valy, King, Jordan B, Pletcher, Mark J, Bibbins-Domingo, Kirsten, Moran, Andrew E, McManus, Richard J, Bellows, Brandon K
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Sprache:eng
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Zusammenfassung:Background Self-monitoring of blood pressure (SMBP) improves blood pressure (BP) outcomes at 12-months, but information is lacking on how SMBP affects hypertension care processes and longer-term BP outcomes. Methods and Results We pooled individual participant data from 4 randomized clinical trials of SMBP in the United Kingdom (combined n=2590) with varying intensities of support. Multivariable random effects regression was used to estimate the probability of antihypertensive intensification at 12 months for usual care versus SMBP. Using these data, we simulated 5-year BP control rates using a validated mathematical model. Trial participants were mostly older adults (mean age 66.6 years, SD 9.5), male (53.9%), and predominantly white (95.6%); mean baseline BP was 151.8/85.0 mm Hg. Compared with usual care, the likelihood of antihypertensive intensification increased with both SMBP with feedback to patient or provider alone (odds ratio 1.8, 95% CI 1.2-2.6) and with telemonitoring or self-management (3.3, 2.5-4.2). Over 5 years, we estimated 33.4% BP control (
ISSN:2047-9980
2047-9980
DOI:10.1161/JAHA.120.016174