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Home blood pressure monitoring ‘reduces inertia’

By Christian Duffin

A meta-analysis of 37 randomised controlled trials has shown that home blood pressure monitoring patients can improve blood pressure control in patients with hypertension.

NICE has recommended GPs use 24-hour ambulatory or home blood pressure monitoring to diagnose hypertension in draft guidance, with a final document due to be published in August.

US researchers studied 37 randomised controlled trials of 9,446 patients with hypertension. Compared to clinic-based measurements taken from patients in a control group, systolic blood pressure was typically 2.63 mmHg lower for those monitoring at home, while diastolic blood pressure was 1.68 mmHg lower.

Patients using home monitoring were twice as like to achieve reductions in antihypertensive medication doses in compared with clinic monitoring.

And therapeutic inertia, defined as no medication change despite high BP, was 18% less likely among home- than clinic-monitored patients.

Study leader Professor Rajiv Agarwal, professor of medicine at Indiana University, concluded: 'Compared with clinic monitoring alone, home monitoring has the potential to overcome therapeutic inertia and lead to a small but significant reduction in systolic and diastolic blood pressure.'

The research is in Hypertension journal. In an accompanying co-authored editorial, professor Giuseppe Mancia, a professor of internal medicine, from University of Milano-Bicocca in Milan, Italy, said the differences could be down to 'an improvement of compliance to treatment, an avoidance of overtreatment, and a reduction of clinical inertia.'

Hypertension 2011; 57: 2938

Home blood pressure monitoring 'reduces inertia'