Self blood pressure monitoring: a worthy substitute for ambulatory blood pressure?

Abstract

lines for self-monitoring of blood pressure (SBPM). We aimed to demonstrate the equivalence of SBPM with ambulatory blood pressure monitoring (ABPM) in the assessment of hypertension. A total of 87 consecutive subjects referred from primary care for standard ABPM underwent a 1-week period of SBPM, as defined by the ESH guidelines, either before or after ABPM. There was no difference in mean blood pressure (BP): SBPM 142/ 87 mm Hg, daytime average ABPM 141/86 mm Hg. The intra-class correlation coefficient was 0.72 and 0.89 for systolic and diastolic pressure, respectively. SBPM is concordant with ABPM in classifying subjects as hypertensive or normotensive in 87% of cases (j ¼ 0.56). The coefficient of variation of SBPM compared with ABPM was 5%. In answer to a direct question 81% of subjects preferred SBPM to ABPM. The current self-monitoring schedule recommended by the ESH, AHA and ASH is valid. The mean BP obtained from SBPM is equivalent to awake-time BP on ABPM, the accepted reference standard for 'out of office' BP measurement. SBPM is simpler to carry out, preferred by patients and should be considered on a par with ABPM.

Home blood pressure measurement in elderly patients with cognitive impairment

“…Despite an excellent agreement between r-HBPM and ABPM (either 24 h or daytime), the difference between r-HBPM and ABPM was larger than published previously [29,31], especially for SBP. However, our study was carried out in very elderly patients with cognitive impairment, two conditions that have been associated with increased WCH and BP variability [5,32,33].…”

“…including 87 hypertensive patients, the k statistic between ABPM and self-HBPM was 0.56 [29]. Other previous studies reported k statistics ranging from 0.32 to 0.73 [30].…”

Accuracy of home versus ambulatory blood pressure monitoring in the diagnosis of white-coat and masked hypertension

“…Home blood pressure monitoring is increasingly used in many communities [8]. Some experts propose that home blood pressure monitoring may be considered as a replacement of ambulatory blood pressure monitoring [9][10][11]. In the present study, we investigated the accuracy of home blood pressure monitoring in the diagnosis of white-coat and masked hypertension in comparison with ambulatory blood pressure monitoring.…”

Patients’ and clinicians’ views on the optimum schedules for self-monitoring of blood pressure: a qualitative focus group and interview study

“…4 Many prefer it, primarily because it promotes independence and control over an individual's own health. [5][6][7] However, self-monitoring largely takes place within the privacy of the patient's home, and thus can be hidden from the patient's clinical care provider. 8 Although the National Institute for Health and Care Excellence (NICE) 1 and international guidelines 3,9 recommend a week of readings for diagnosis, most primary care healthcare professionals (HCPs) use self-monitoring for ongoing management, 10 for which there are no evidence-based recommendations on what type of self-monitoring schedule to implement.…”