Blood pressure control by home monitoring : meta-analysis of randomised trials
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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Official URL: http://dx.doi.org/10.1136/bmj.38121.684410.AE
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
|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|
|Access rights to Published version:||Open Access|
1 Collins R, Peto R, MacMahon S, Hebert P, Fiebach NH, Eberlein KA, et al. Blood pressure,
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