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Optimizing Home Blood Pressure Monitoring Protocols in Older Adults: The Atherosclerosis Risk in Communities (ARIC)
Frances M Wang1,2, Hannah Col1, Fredrick Larbi Kwapong1
1Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
American Journal of Hypertension
|July 11, 2026
Summary
Home blood pressure monitoring (HBPM) can be valid in just three days. Shorter, less burdensome protocols using morning and evening sessions with at least two readings each are recommended for hypertension management.
Area of Science:
- Cardiovascular Medicine
- Gerontology
- Clinical Hypertension Research
Background:
- Home blood pressure monitoring (HBPM) is crucial for hypertension diagnosis and management.
- Current guidelines lack established optimal protocols for HBPM measurement frequency.
Purpose of the Study:
- To determine the minimum number of home blood pressure monitoring (HBPM) measurements for valid hypertension assessment.
- To evaluate streamlined HBPM protocols against a comprehensive eight-day protocol and ambulatory BP.
Main Methods:
- An eight-day HBPM protocol with morning/evening measurements and three readings per session was conducted.
- Validity of streamlined protocols (fewer days, readings, or timepoints) was assessed.
- Secondary analysis compared HBPM protocols to ambulatory blood pressure monitoring.
Main Results:
- Stable blood pressure estimates were achieved within three days of HBPM.
- Concordance correlation coefficients exceeded 0.95 by day three.
- Averaging at least two readings per session, morning and evening, improved validity.
Conclusions:
- Three days of home blood pressure monitoring (HBPM), with morning and evening sessions and ≥2 readings each, provide valid estimates in older adults.
- Shorter, less burdensome HBPM protocols can support hypertension management guidelines.
- Generalizability beyond this cohort requires further study.
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