Self-monitoring helps hypertensive patients to drop BP rates

Self-monitoring by patients with hypertension led to a drop in blood-pressure levels over the course of a year, according to research published this week in the Journal of the American Medical Association.

The study--part of the U.K.-based University of Birmingham's targets and self-management for the control of blood pressure in stroke and at-risk groups (TASMIN-SR) trial--involved 552 patients who were at least 35 years old and had a history of stroke, coronary heart disease and high-blood pressure; 230 of those patients participated in the self-monitoring group and overall data was available from 450 participants.

Based on readings received, the interventional group adjusted their own medication levels.

Mean blood pressure at the beginning of the trial for self-monitoring patients was 143.1/80.5 mm Hg; after 12 months, that figure dropped to 128.2/73.8. For patients in the control group, mean blood-pressure prior to the start of the project was 143.6/79.5; afterward, it fell to 137.8/76.3.

Lead study author Richard McManus, of the National Institute for Health Research School for Primary Care Research at the University of Oxford in the U.K., told heartwire that he and his colleagues found no increased risk above usual care methods.

"The key prerequisite is that is that this is a joint approach between physician and patient," McManus told heartwire. "We are not recommending patients try this on their own."

In an accompanying editorial in JAMA, Peter Nilsson, M.D., of the department of clinical sciences at Lund University in Sweden, and Fredrik Nystrom, M.D., with the department of medical and health sciences at Linkoping University in Sweden, stressed the critical nature of the research for patients at high-risk of cardiovascular disease.

"The findings reported by McManus ... represent an important gain in knowledge about the efficacy and safety of self-titration of antihypertensive drugs based on home blood pressure recordings using fairly inexpensive oscillometric devices," Nilsson and Nystrom said.

Similar research published last summer by the Agency for Healthcare Research and Quality found that self-monitoring can help patients improve their blood pressure, but the effects tend not to last unless doctors also provide support services.

Still, the use of remote monitoring technology to guide care for patients with hypertension has been shown to be beneficial in many different ways. For instance, home BP monitoring was determined to be cost beneficial for insurers, according to research published in the journal Hypertension last month.

Additionally, a telemedicine support program in which patients with uncontrolled hypertension used an app that transmitted data to their electronic records helped to improve BP readings.

To learn more:
- here's the JAMA article
- here's the accompanying editorial
- check out the heartwire article