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Self-monitoring linked with better blood pressure control

Patients who self-monitor their blood pressure have lower blood pressure, but the effect only lasts for the first year, suggests a new evidence review.

The study

The systematic review included 13,603 patients from 52 prospective comparative studies looking at self-monitoring of blood pressure with or without additional support, versus usual care. The follow-up period was a minimum of eight weeks. Self-measuring was conducted in the patient’s home, either by the patient or a companion. All patients were adults being managed for hypertension.

The results

For self-monitoring alone there was ‘moderate-strength’ evidence for lower blood pressure at six months, versus normal care, with weighted mean differences for systolic and diastolic blood pressure of -3.9mmHg and -2.4 mmHg, respectively. These differences were not observed at 12 months. For self-monitoring plus additional support there was ‘high-strength’ evidence supporting a lower blood pressure with use of self-monitoring, versus usual care, ranging from -3.4 to -8.9 mmHg for systolic blood pressure and from -1.9 to -4.4mmHg for diastolic blood pressure at 12 months. There was little strong evidence to support a difference between self-monitoring plus additional support and self-monitoring alone.

What this means for GPs

The researchers note that ‘self-monitoring with or without additional support lowers blood pressure compared with usual care’ but advise that ‘the BP effect beyond 12 months and long-term benefits remain uncertain’. Additional support enhances the blood pressure-lowering effect.

Ann Intern Med 2013, online 6 Aug

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