Cappuccio, Francesco P., Kerry, Sally M., Forbes, Lindsay and Donald, Anna. (2004) Blood pressure control by home monitoring : meta-analysis of randomised trials. BMJ, Vol.329 (No.7458). ISSN 0959-535X

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Abstract

Objective To determine the effect of home blood pressure monitoring on blood pressure levels and proportion of people with essential hypertension achieving targets. Design Meta-analysis of 18 randomised controlled trials. Participants 1359 people with essential hypertension allocated to home blood pressure monitoring and 1355 allocated to the "control" group seen in the healthcare system for 2-36 months. Main outcome measures Differences in systolic (13 studies), diastolic (16 studies), or mean (3 studies) blood pressures, and proportion of patients achieving targets (6 studies), between intervention and control groups. Results Systolic blood pressure was lower in people with hypertension who had home blood pressure monitoring than in those who had standard blood pressure monitoring in the healthcare system (standardised mean difference 4.2 (95% confidence interval 1.5 to 6.9) mm Hg), diastolic blood pressure was lower by 2.4 (1.2 to 3.5) mm Hg, and mean blood pressure was lower by 4.4 (2.0 to 6.8) mm Hg. The relative risk of blood pressure above predetermined targets was lower in people with home blood pressure monitoring (risk ratio 0.90, 0.80 to 1.00). When publication bias was allowed for, the differences were attenuated: 2.2 ( − 0.9 to 5.3) mm Hg for systolic blood pressure and 1.9 (0.6 to 3.2) mm Hg for diastolic blood pressure. Conclusions Blood pressure control in people with hypertension (assessed in the clinic) and the proportion achieving targets are increased when home blood pressure monitoring is used rather than standard blood pressure monitoring in the healthcare system. The reasons for this are not clear. The difference in blood pressure control between the two methods is small but likely to contribute to an important reduction in vascular complications in the hypertensive population.

Item Type:	Journal Article
Subjects:	Q Science > QP Physiology
Divisions:	Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Blood pressure -- Measurement, Hypertension, Home care services, Patient self-monitoring
Journal or Publication Title:	BMJ
Publisher:	BMJ Group
ISSN:	0959-535X
Date:	2004
Volume:	Vol.329
Number:	No.7458
Identification Number:	10.1136/bmj.38121.684410.AE
Status:	Peer Reviewed
Access rights to Published version:	Open Access
Funder:	Bristol-Meyers Squibb
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URI:	http://wrap.warwick.ac.uk/id/eprint/4349

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