Self‐blood pressure monitoring as a tool to increase hypertension awareness, adherence to antihypertensive therapy, and blood pressure control

Abstract

For many years, casual blood pressure (BP) taken by a sphygmomanometer in the clinic or at the physician's office has been used as the standard method for diagnosing hypertension. Even if such measurement has been the cornerstone on which our understanding of the consequences of hypertension is based, there is a huge and very consistent body of evidence indicating that casual measurements of BP may provide a very unreliable index for the evaluation of hypertension because of their variability.The two alternative ways of measuring BP that have been most commonly used are measurements made at home by the patient himself (home or self-BP monitoring-SBPM) and measurements by ambulatory blood pressure recorders. 1 Results obtained by these methods have given closer correlation with a variety of measures of hypertensive end-organ complications than casual or office BP. 1-3 Furthermore, the prognostic studies indicate that BP measurements performed in "out-of-office" settings (using both home and ambulatory monitoring) are superior to office BP in predicting cardiovascular morbidity and mortality. 1,4 Moreover, SBPM is a practical, reproducible, easy-to-learn, and economical way to reduce some of the pitfalls of relying exclusively on readings taken in the clinic. Most current self-monitoring electronic devices are relatively cheap, simple to operate, will remove observer bias, and allow for multiple measurements in a short time.In addition, it may be possible to reduce or to eliminate the "whitecoat effect" that influences office BP readings. 1 It has been known since the classic study of Ayman and Goldshine in 1940 that home recordings are generally lower than office readings. 5 These authors, working in Boston at Beth Israel Hospital, reasoned that the home environment might be more conducive to obtaining BP readings without the stress associated with an office or clinic visit, recognizing that measurements of pressure at home, outside the clinic, might provide a more accurate assessment of patients' usual BP. Clearly, these authors had identified what is now called "white-coat" or clinic hypertension, although they did not coin these terms. They were the first to propose the concept of "self-BP measurement", pioneeringly suggesting that home BP monitoring was useful for (a) instructing the patients about their chronic diseases, (b) teaching physicians about the natural course of the disease and about factors that affect the disease, (c) learning the prognosis of disease, and (d) increasing the precision of determining the effectiveness of treatment. 5Nowadays, progress in technology has offered novel approaches to telemonitoring of BP values measured at a patient's home. Blood pressure telemonitoring (BPT) is a telehealth strategy that allows remote data transmission of BP and other information on patients' health status from their dwellings or from a community setting to the doctor's office or the hospital. 6,7 For all the above reasons, the use of HBPM is recommended by several national and international guideline...

Prevalence, awareness, and control of hypertension and associated factors among Royal Thai Army personnel in Thailand from 2017 to 2021

“…Therefore, enhancing health literacy and awareness efforts aimed at men (approximately 90% of RTA personnel), for instance, peer-led interventions and incremental community empowerment, may modify cultural institutions to fortify helpful health behaviours among military personnel 31 , 34 , 35 . In addition, providing an automatic BP machine at military units for self-BP monitoring may be a tool to increase HTN awareness 36 .…”

Psychometric Testing of the Self-care of Hypertension Inventory Version 3.0

“…Persons with HTN are increasingly encouraged to self-monitor their BP, record BP readings, and review their records with their healthcare providers 35 . Advances in technology have made self-monitoring easy, reliable, and accurate and allow for electronic transmission 36 . Thus, the SC-HI v3.0 self-care management items may reflect behaviors consistent with autonomy.…”

“…35 Advances in technology have made self-monitoring easy, reliable, and accurate and allow for electronic transmission. 36 Thus, the SC-HI v3.0 self-care management items may reflect behaviors consistent with autonomy. We also removed item 17 (ie, symptom recognition) from the management scale.…”

Evaluating a WeChat-Based Health Behavioral Digital Intervention for Patients With Hypertension: Protocol for a Randomized Controlled Trial

“…Following various types of recommended exercise led to an SBP reduction of 7.23-8.69 mm Hg [ 10 ]. Improving BP monitoring adherence behavior resulted in SBP and DBP reductions of 2.53-4.2 and 1.45-2.4 mm Hg, respectively [ 11 ]. High medication adherence, combined with comprehensive interventions such as diet and exercise management, can achieve better BP control effects [ 12 , 13 ].…”