we don’t take our blood pressure well at home

Despite guideline recommendations and improved access to healthcare, It is unlikely that people with hypertension take their blood pressure at home as often as recommendedaccording to data from researchers at Massachusetts General Hospital (United States).

In a retrospective cohort study, researchers found that even with free blood pressure devices, education and personalized supportpatient participation in home blood pressure monitoring remained low, highlighting the need for more practical and less cumbersome monitoring tools. The findings are published in JAMA Cardiology.

Previous research suggests that home blood pressure measurements are often more accurate than in-clinic readings. Current guidelines from the American Heart Association recommend that patients with hypertension take two readingsone minute apart, twice a day for up to seven days to obtain an accurate average before a clinical consultation.

“A single blood pressure reading at the doctor’s office can be misleading”reflects Dr. Naomi Fisher, lead author and endocrinologist in the Division of Endocrinology, Diabetes and Hypertension in the Department of Medicine at Brigham General Hospital in Massachusetts. “Stress, recent physical activity, or anxiety during a consultation they can artificially raise readings. By taking multiple measurements daily at home over several days, we get a much more accurate picture of the patient’s actual blood pressure and can tailor treatment more effectively.”

The researchers conducted a retrospective cohort study with 3,390 patients enrolled in a remote hypertension monitoring program, conducted between September 2018 and June 2022. The program aimed to evaluate whether home blood pressure monitoring could effectively reduce blood pressure. All participants received training and free blood pressure monitors for homeand they were asked to complete 28 weekly readingswhich were automatically transmitted to patient navigators. Notably, the main analysis showed that participants who actively measured their blood pressure at home and reached the maintenance level achieved drops in blood pressure associated with a 40% reduction in risk relative risk of major cardiovascular events and all-cause mortality.

This study focuses on a secondary analysis focusing on patient engagement with home blood pressure monitoring. In this study, researchers recorded the number of readings taken over seven days to assess patient participation. Participation levels were classified as null (0 measurements completed), low (1-11 measurements completed), intermediate (12-23 measurements completed) and high (24-28 measurements completed). Participation in home blood pressure monitoring varied: 32.7% showed zero participation, 14.3% showed low participation, and 18.2% and 34.8% showed intermediate and high participation.respectively.

The authors note that these findings highlight the need for most innovative and easy-to-use wearable devicessimilar to continuous glucose monitoring devices used for diabetes management. The idea would be to collect blood pressure readings passively to reduce the burden on patients.

The researchers aim to focus their future research on understanding the specific barriers patients face with home blood pressure monitoring that contribute to their low participation. With several new devices in development or awaiting U.S. Food and Drug Administration approval, they are also evaluating how hypertension treatment outcomes differ among patients. who use traditional monitors and those who use new portable continuous monitoring systems.

“Current guidelines call for frequent, carefully scheduled blood pressure measurements to ensure accuracy, but the reality of patients’ lives often makes this unrealistic,” said senior author Ozan Unlu, a member of the Interventional Cardiology team at the Brigham Cardiovascular Institute at Massachusetts General. “This gap highlights the need for low impact technologies that capture reliable blood pressure data without forcing patients to rearrange their lives to manage their condition.”