There's no place like home...to track blood pressure

Date:
September 28, 2021
Source:
American Heart Association
Summary:
Adults with elevated blood pressure who had not been diagnosed
with high blood pressure found that monitoring their blood
pressure at home was more acceptable than going to a kiosk,
clinic or using a 24-hour wearable monitoring device. Adults were
more likely to record the minimum number of measurements with
at-home or clinic-based blood pressure monitoring versus going
to a kiosk. Adults found the 24-hour wearable blood pressure
measuring device least acceptable among the options. Health care
professionals should consider talking with people who have high
blood pressure about the option of home monitoring and providing
the tools and education necessary to do it correctly.



FULL STORY ========================================================================== Adults who needed to track their blood pressure regularly to confirm
or refute a hypertension diagnosis preferred monitoring blood pressure
at home versus at a clinic, kiosk or with a 24-hour wearable device,
according to preliminary research presented today at the American Heart Association's Hypertension Scientific Sessions 2021. The meeting is
the premier scientific exchange focused on recent advances in basic
and clinical research on high blood pressure and its relationship to
cardiac and kidney disease, stroke, obesity and genetics, and is being
held virtually Sept. 27-29, 2021.


========================================================================== According to the American Heart Association, about 1 of every 2 of
U.S. adults has high blood pressure, or hypertension. More than one in
three adults with high blood pressure might not know they have it. High
blood pressure is defined as having a systolic pressure (the top number
in a reading) of 130 mm Hg or higher, or a diastolic pressure (the bottom number) of 80 mm Hg or higher.

"Most hypertension is diagnosed and treated based on blood pressure measurements taken in a doctor's office, even though the U.S. Preventive Services Task Force and the American Heart Association recommend that
blood pressure measurements be taken outside of the clinical setting
to confirm the diagnosis before starting treatment," said lead study
author Beverly Green, M.D., M.P.H., senior investigator and family
physician at Kaiser Permanente Washington Health Research Institute and
Kaiser Permanente Washington in Seattle. "It is the standard that blood pressure monitoring should be done either using home blood pressure
monitoring or 24-hour ambulatory blood pressure monitoring prior to
diagnosing hypertension." 24-hour ambulatory blood pressure monitoring devices, worn day and night to take continuous blood pressure readings,
are generally considered the "gold standard" for out-of-office measurement
to determine a diagnosis of high blood pressure. However, blood pressure measured on a home device, with a traditional blood pressure arm cuff,
can be a more practical and convenient approach.

Green and colleagues studied adherence and acceptability of different
blood pressure measuring methods among 510 adults who had elevated blood pressure yet had not been diagnosed with high blood pressure. They were participants in the Blood Pressure Checks for Diagnosing Hypertension (BP-CHECK) trial.

Participants in the study were an average age of 59 years old; 75% were
non- Hispanic white, 7% African American, 6% Asian, 5% Hispanic white
and 7% other; half were male; and the average blood pressure was 150/88
mm Hg. None of the participants were taking blood pressure-lowering medications.

Participants were randomly assigned to one of three groups for determining
a new diagnosis of hypertension: clinic measurements, home monitoring
or kiosk blood pressure monitoring.

Those in the group for clinic measurements were asked to return to the
clinic for at least one additional blood pressure check, as is routine
in diagnosing hypertension in clinical practice. The home group received
home blood pressure machines, were trained to use them and were asked to
take their blood pressure twice a day with two measurements each time,
for five days, for a total of 20 measurements. The kiosk group was asked
to take their blood pressure at a kiosk in their clinic or at a nearby
pharmacy on three separate days, with three measurements each time, for
a total of nine measurements. All participants were asked to complete
their group-assigned diagnostic regimens within 3 weeks, and then to
complete 24-hour ambulatory blood pressure monitoring. Researchers
compared adherence to and the acceptability among each diagnostic method.

They measured adherence to monitoring by noting the percent of individuals
in each group who completed their assigned measurement method as
instructed. They measured acceptability with questionnaires.

Researchers found:
* Overall acceptability was highest for the at-home group, followed
by the
clinic and kiosk groups. 24-hour ambulatory blood pressure
monitoring was the least acceptable option.

* Participants were least likely to adhere to the monitoring regimen
in the
kiosk group. Adherence was more than 90% among those in the home
testing group; more than 87% in the clinic group; nearly 68% in
the kiosk group; and 91% for 24-hour ambulatory monitoring among
all participants.

"Home blood pressure 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," Green said. "Participants reported that ambulatory blood pressure monitoring disturbed daily and
work activities, disrupted sleep and was uncomfortable." When asked
which diagnostic testing regimen they would prefer, more than half chose
home blood pressure monitoring, especially if they were assigned to the
home group, where almost 80% preferred home monitoring.

Green suggests health care professionals routinely offer home blood
pressure monitoring to their patients with elevated blood pressure. This
might involve providing home blood pressure monitors, training patients
and collecting and averaging several days of blood pressure readings.

========================================================================== Story Source: Materials provided by American_Heart_Association. Note:
Content may be edited for style and length.


==========================================================================


Link to news story: https://www.sciencedaily.com/releases/2021/09/210928102219.htm

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