BP monitoring at home gathers most “likes” vs other methods

People who need to check their blood pressure (BP) regularly to confirm if they have hypertension prefer BP monitoring done at home rather than at a clinic, kiosk, or through a 24-hour ambulatory BP monitoring (ABPM), suggest findings from the Blood Pressure Checks for Diagnosing Hypertension (BP-CHECK) trial presented at Hypertension 2021.

“Home BP monitoring was the most preferred option because it was convenient, easy to do, did not disturb their daily personal or work routine as much, and was perceived as accurate,” explained lead author Dr Beverly Green, who is a researcher and a  family physician at Kaiser Permanente Washington Health Research Institute and Kaiser Permanente Washington in Seattle, Washington, US.

“Participants reported that ABPM disturbed daily and work activities, disrupted sleep, and was uncomfortable,” he said.

The study involved 510 adults (mean age 59 years, 51 percent male, 80 percent Caucasians) who presented with elevated BP but yet to have a hypertension diagnosis to primary care clinics under Kaiser Permanente Washington. They were randomized to monitor their BP at office, home, or kiosk. All participants also underwent ABPM for comparison. Their adherence and acceptability of each method were assessed using a validated questionnaire. None of them were on antihypertensive medications. [Hypertension 2021, abstract 50]

Overall, at-home BP monitoring gathered the greatest acceptability (mean score, 6.2), while ABPM was the least acceptable option (mean score, 5.0). The mean scores for monitoring at clinic and kiosk were 5.5 and 5.4, respectively.  

In addition, people were most likely to adhere to BP monitoring at home (90.6 percent), followed by at the clinic (87.2 percent), and least adherent to monitoring at kiosk (67.9 percent). The adherence for 24-hour ABPM was 91 percent overall in the entire population.

“Most hypertension is diagnosed  and treated based on BP measurements taken in a doctor’s office, even though the US Preventive Services Task Force and the American Heart Association recommend that BP measurements be taken outside of the clinical setting to confirm the diagnosis before starting treatment,” said Green.

“It is the standard that BP monitoring should be done either using home BP monitoring or 24-hour ABPM prior to diagnosing hypertension,” he pointed out. Although 24-hour ABPM is considered the “gold standard” for out-of-office evaluation to confirm a hypertension diagnosis, BP measured using a home device with a BP arm cuff presents a more convenient and practical approach.

“Healthcare professionals should work toward relying less on in-clinic visits to diagnose hypertension and supporting their patients in taking their BP measurements at home,” urged Green.

“Home BP monitoring is empowering and improves our ability to identify and treat hypertension, and to prevent strokes, heart attacks, heart failure, and cardiovascular death,” he added.