Guidance on home blood pressure monitoring: A statement of the HOPE Asia Network

Abstract

Hypertension is an important modifiable cardiovascular risk factor and a leading cause of death throughout Asia. Effective prevention and control of hypertension in the region remain a significant challenge despite the availability of several regional and international guidelines. Out‐of‐office measurement of blood pressure (BP), including home BP monitoring (HBPM), is an important hypertension management tool. Home BP is better than office BP for predicting cardiovascular risk and HBPM should be considered for all patients with office BP ≥ 130/85 mm Hg. It is important that HBPM is undertaken using a validated device and patients are educated about how to perform HBPM correctly. During antihypertensive therapy, monitoring of home BP control and variability is essential, especially in the morning. This is because HBPM can facilitate the choice of individualized optimal therapy. The evidence and practice points in this document are based on the Hypertension Cardiovascular Outcome Prevention and Evidence (HOPE) Asia Network expert panel consensus recommendations for HBPM in Asia.

Home blood pressure control status in 2017‐2018 for hypertension specialist centers in Asia: Results of the Asia BP@Home study

“…To avoid reporting bias, BP data were automatically stored in device memory, then entered into the study database by a physician or nurse. Home BP measurements were performed according to the Expert Panel Consensus Recommendations for HBPM (the HOPE Asia Network), 26,27 which modified guidelines from the European Society of Hypertension (ESH), 11,12 Japanese Society of Hypertension (JSH), 13 and the Korean Society of Hypertension, 37 and the China consensus document on HBPM. 38 Patients measured their BP at home using the device provided twice in the morning (morning home BP) and twice at bedtime (evening home BP) as follows.…”

“…4,13,15,16 Again, this is likely to be of greater importance in Asia due to the presence of Asian-specific characteristics in the 24-hour BP profile. 13,[25][26][27] There are several studies highlighting the importance of home BP for improving cardiovascular prognosis. 17,[20][21][22][23][24] A self-measured home BP-guided strategy has been stressed as the most effective practical approach of the management of hypertension in Asia.…”

“…17,[20][21][22][23][24] A self-measured home BP-guided strategy has been stressed as the most effective practical approach of the management of hypertension in Asia. 13,[25][26][27] There are several studies highlighting the importance of home BP for improving cardiovascular prognosis. [28][29][30][31][32][33] However, the findings of some of these studies are limited due to a lack of standardization in the BP measurement schedule, BP measurement device, and recording of home BP measurements, as well as a lack of measurement of nocturnal BP, which is an emerging important cardiovascular risk factor.…”

Asian management of hypertension: Current status, home blood pressure, and specific concerns in Indonesia

“…Current use of HBPM in Indonesia is based on guidance from the HOPE Asia Network and the 2019 Indonesian Society of Hypertension (InaSH) . The new InaSH hypertension consensus was launched at the society's 2019 meeting, which highlighted the vital role of HBPM and provided guidelines for its use .…”

Validation of two watch‐type wearable blood pressure monitors according to the ANSI/AAMI/ISO81060‐2:2013 guidelines: Omron HEM‐6410T‐ZM and HEM‐6410T‐ZL

“…Home blood pressure (BP) measurement is widely used and recommended for the management of hypertension. [1][2][3][4][5] Several studies have reported that home BP measured by an automatic cuff-oscillometric device has greater predictive power for cardiovascular (CV) outcomes than clinic BP. 6,7 Moreover, there is a common phenomenon known as masked hypertension (MHT) defined by out-of-clinic BP in the hypertensive range among individuals with normal-range clinic BP.…”