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Home Blood Pressure Monitoring
Justin Liu1, Jeffrey Brettler2, Uriel A Ramirez1
1Department of Medicine, Columbia Hypertension Lab, Columbia University Irving Medical Center, New York, New York, USA.
Insights
Home Blood Pressure Monitoring (HBPM) offers advantages over traditional methods for diagnosing and managing hypertension. This review explores HBPM
Area of Science:
- Cardiology
- Hypertension Management
- Preventive Medicine
Background:
- Office blood pressure (BP) measurement is standard for hypertension diagnosis and management.
- Out-of-office BP, particularly higher readings, correlates with increased cardiovascular disease risk.
- Home Blood Pressure Monitoring (HBPM) is a validated method for out-of-office BP assessment.
Purpose of the Study:
- To provide a state-of-the-art review of Home Blood Pressure Monitoring (HBPM).
- To discuss recent hypertension guidelines, telemonitoring integration, and self-titration of medications with HBPM.
- To examine HBPM device validation, clinical best practices, implementation strategies, health equity, and use in specific populations.
Main Methods:
- Review of current literature and recent hypertension guidelines.
- Analysis of the advantages of HBPM compared to Ambulatory Blood Pressure Monitoring (ABPM).
- Exploration of HBPM's role in conjunction with telemonitoring and self-management.
Main Results:
- HBPM provides valuable data for hypertension diagnosis and management.
- HBPM offers advantages over ABPM, including better basal BP measurement and wider availability.
- Telemonitoring combined with HBPM demonstrates efficacy in improving BP control.
Conclusions:
- HBPM is a crucial tool for accurate hypertension assessment and management.
- Integrating HBPM with telemonitoring and self-titration strategies can enhance BP control.
- Further research is needed to address research gaps and explore future directions for HBPM.
Abstract:
The diagnosis and management of hypertension have been based primarily on blood pressure (BP) measurement in the office setting. Higher out-of-office BP is associated with an increased risk of cardiovascular disease, independent of office BP. Home BP monitoring (HBPM) consists of the measurement of BP by a person outside of the office at home and is a validated approach for out-of-office BP measurement. HBPM provides valuable data for diagnosing and managing hypertension. Another validated approach, ambulatory BP monitoring (ABPM), has been considered to be the reference standard of out-of-office BP measurement. However, HBPM offers potential advantages over ABPM including being a better measure of basal BP, wide availability to patients and clinicians, evidence supporting its use for better office BP control, and demonstrated efficacy when using telemonitoring along with HBPM. This state-of-the-art review examines the current state of HBPM and includes discussion of recent hypertension guidelines on HBPM, advantages of using telemonitoring with HBPM, use of self-titration of antihypertensive medication with HBPM, validation of HBPM devices, best practices for conducting HBPM in the clinical setting, how HBPM can be used as an implementation strategy approach to improve BP control in the United States, health equity in HBPM use, and HBPM use among specific populations. Finally, research gaps and future directions of HBPM are reviewed.
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