Practice and awareness of physicians regarding home blood pressure measurement in Japan

Area of Science:

• Cardiology
• Public Health
• Medical Education

Background:

• The Japanese Society of Hypertension released guidelines for home blood pressure (HBP) measurement in 2003 and hypertension management in 2004.
• Assessing physician adherence and understanding of these guidelines is crucial for effective hypertension control.

Purpose of the Study:

• To evaluate Japanese physicians' practices and awareness regarding HBP measurement based on national guidelines.
• To compare physician knowledge and practices immediately after guideline publication versus four years later.

Main Methods:

• A questionnaire survey was administered to physicians attending hypertension educational seminars in 2004-05 and 2007-08.
• Data collected included recommendations for HBP measurement, device usage, measurement frequency, documentation, evaluation, and understanding of guidelines.
• Response rates were high, with 1966 physicians in 2004-05 and 2995 in 2007-08.

Main Results:

• Over 90% of physicians recommended HBP measurement, with most advising upper-arm cuff devices.
• Knowledge of optimal HBP measurement methods and correct hypertension reference values (135/85 mm Hg) remained low (around 10% and 21-24%, respectively) in both survey periods.
• Significant variation existed in recommendations for measurement frequency, documentation, and evaluation.

Conclusions:

• Despite recognizing the importance of HBP measurement, many Japanese physicians exhibit inadequate knowledge of guideline-recommended practices.
• There was no substantial improvement in optimal HBP measurement knowledge or understanding of reference values four years post-guideline release.
• More aggressive promotion and education regarding HBP measurement guidelines among physicians are warranted.