Self-monitoring, self-titrating hypertension meds benefit high-risk patients

Coupling self-monitoring with self-titration of antihypertensives resulted in lower systolic blood pressure at 12 months, compared with usual care.

Self-monitoring with self-titration may lower blood pressure in high-risk patients.
Self-monitoring with self-titration may lower blood pressure in high-risk patients.

HealthDay News -- For patients with hypertension at risk of cardiovascular disease, self-monitoring with self-titration of antihypertensive medications is associated with lower blood pressure, according to researchers.

In order to examine the effect of self-monitoring and self-titration of antihypertensive medication versus usual care among patients with hypertension and cardiovascular disease, diabetes, or chronic kidney disease, Richard J. McManus, PhD, of the University of Oxford in the United Kingdom, and colleagues examined data in 450 patients aged 35 years and older. 

The baseline blood pressure of patients was at least 130/80 mm Hg. Patients were randomly assigned to receive self-monitoring of blood pressure combined with an individualized self-titration algorithm or usual care. Baseline blood pressure was 143.1/80.5 and 143.6/79.5 mm Hg in the intervention and control groups, respectively.

The mean blood pressure decreased after 12 months to 128.2/73.8 in the study group and 137.8/76.3 mm Hg in the control group, a difference of 9.2 and 3.4 mm Hg in systolic and diastolic blood pressures, respectively, after adjustment for baseline blood pressure.

Results were similar after multiple imputation for missing values. Comparable results were obtained in all subgroups, without excessive adverse events.

"Among patients with hypertension at high risk of cardiovascular disease, self-monitoring with self-titration of antihypertensive medication compared with usual care resulted in lower systolic blood pressure at 12 months," concluded the researchers.

References

  1. McManus R et al. JAMA. 2014; doi: 10.1001/jama.2014.10057

Disclosures: Several authors disclosed financial ties to the medical device and health care industries.

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