Home blood pressure measurement for hypertension management in the real world: Do not just measure, but share with your physician

Moo-Yong Rhee; Masanori Munakata; Deuk-Young Nah; Je Sang Kim; Hae-Young Kim

doi:10.3389/fcvm.2023.1103216

Home blood pressure measurement for hypertension management in the real world: Do not just measure, but share with your physician

Front Cardiovasc Med. 2023 Jan 18:10:1103216. doi: 10.3389/fcvm.2023.1103216. eCollection 2023.

Authors

Moo-Yong Rhee^{1

2}, Masanori Munakata³, Deuk-Young Nah^{2

4}, Je Sang Kim^{1

2}, Hae-Young Kim⁵

Affiliations

¹ Cardiovascular Center, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea.
² College of Medicine, Dongguk University, Gyeongju-si, Gyeongsangbuk-do, Republic of Korea.
³ Division of Hypertension and Research Center for Lifestyle-Related Disease, Tohoku Rosai Hospital, Sendai, Japan.
⁴ Cardiovascular Center, Dongguk University Gyeongju Hospital, Gyeongju-si, Gyeongsangbuk-do, Republic of Korea.
⁵ Department of Health Policy and Management, College of Health Science and Department of Health Care Sciences, Graduate School and BK21 FOUR R&E Center for Learning Health Systems, Korea University, Seoul, Republic of Korea.

Abstract

Introduction: Studies of the effectiveness of home blood pressure (BP) measurement on the treatment of hypertension in the real world are sparse, and the results are controversial. There is an efficacy-effectiveness gap in the treatment of hypertension using home BP measurements. We aimed to investigate the effect of reporting home BP to physicians on ambulatory BP control as a factor contributing to the efficacy-effectiveness gap in treating patients with hypertension.

Methods: We recruited patients ≥20 years of age taking antihypertensive drugs. Office and 24-h ambulatory BP were measured. A questionnaire to the measurement of home BP was conducted. Participants were divided into an HBPM(-) group, home BP was not measured (n = 467); HBPM(+)-R(-) group, home BP was measured but not reported (n = 81); and HBPM(+)-R(+) group, home BP was measured and reported (n = 125).

Results: The HBPM(+)-R(+) group had significantly lower office systolic BP (SBP, p = 0.035), 24-h SBP (p = 0.009), and daytime SBP (p = 0.016) than the HBPM(-) group, and lower nighttime SBP (p = 0.005) and diastolic BP (DBP, p = 0.008) than the HBPM(+)-R(-) group. In the multivariate analysis, the differences in 24-h SBP, daytime SBP, and nighttime DBP remained significant. There was a significant difference between groups in the target achievement rate of 24-h SBP (p = 0.046), nighttime SBP (p = 0.021), and nighttime DBP (p = 0.023). The nighttime SBP and DBP target achievement rates in the HBPM(+)-R(+) group were higher than those in the HBPM(+)-R(-) group (p = 0.006 and 0.010, respectively). Among patients measuring home BP, the adjusted odds ratio for 24-h and nighttime BP target achievement in the HBPM(+)-R(+) group were 2.233 and 3.658, respectively.

Conclusion: Home BP measurements should be reported to the treating physician to effectively manage hypertension.

Clinical trial registration: https://clinicaltrials.gov, identifier NCT03868384.

Keywords: ambulatory; blood pressure; home; hypertension; treatment.

Associated data

ClinicalTrials.gov/NCT03868384