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A cardiovascular risk clinic using home BP monitoring

Patrick D Byrnes1, Geoffrey K Mitchell, Margaret V Crawford

  • 1Rural Clinical School, University of Queensland, and a general practitioner, Bundaberg, Queensland. patrick@apmc.net.au

Australian Family Physician
|March 14, 2009
PubMed

Insights

Home blood pressure (HBP) monitoring in general practice improved hypertension control rates from 29.9% to 44.8%. This approach offers a feasible management protocol for better blood pressure control.

Area of Science:

  • Cardiology
  • General Practice
  • Public Health

Background:

  • Hypertension is a prevalent chronic condition managed in general practice.
  • Suboptimal blood pressure (BP) control remains a significant challenge.
  • Home blood pressure (HBP) monitoring offers greater accuracy than office-based BP (OBP) monitoring.

Purpose of the Study:

  • To evaluate the effectiveness of a cardiovascular risk review clinic utilizing HBP monitoring in a general practice setting.
  • To assess improvements in BP control rates and home BP monitor ownership.
  • To establish a feasible management protocol and performance indicators for future randomized controlled trials.

Main Methods:

  • A cohort of hypertensive patients from a single general practice was invited to a specialized clinic.
  • The clinic incorporated HBP monitoring and aimed for adjusted BP targets based on age (<65 years: 120/80 mmHg; >65 years: 130/85 mmHg).
  • Data collected included BP readings, achievement of BP targets, home BP monitor ownership, enrollment, and 12-month follow-up attendance.

Main Results:

  • Out of 524 eligible patients, 414 (79%) enrolled, with 89% completing the 12-month follow-up.
  • Blood pressure control rates significantly increased from 29.9% to 44.8% (p<0.001).
  • Mean HBP decreased by 5.2/3.2 mmHg, and home BP monitor ownership rose from 54.3% to 82.9%.

Conclusions:

  • This study demonstrates the first comprehensive clinic approach exclusively using HBP readings in Australian general practice.
  • The findings suggest a feasible management protocol and practical indicators for clinical trials.
  • The intervention resulted in significantly better BP control rates compared to previously published studies.
Abstract

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