Skip to main content
SpringerLink
Log in

Self-monitoring in hypertension: a web-based survey of primary care physicians

  • Original Article
  • Published:
Journal of Human Hypertension Submit manuscript

Abstract

Although self-monitoring of blood pressure is common among people with hypertension, little is known about how general practitioners (GPs) use such readings. This survey aimed to ascertain current views and practice on self-monitoring of UK primary care physicians. An internet-based survey of UK GPs was undertaken using a provider of internet services to UK doctors. The hyperlink to the survey was opened by 928 doctors, and 625 (67%) GPs completed the questionnaire. Of them, 557 (90%) reported having patients who self-monitor, 191 (34%) had a monitor that they lend to patients, 171 (31%) provided training in self-monitoring for their patients and 52 (9%) offered training to other GPs. Three hundred and sixty-seven GPs (66%) recommended at least two readings per day, and 416 (75%) recommended at least 4 days of monitoring at a time. One hundred and eighty (32%) adjusted self-monitored readings to take account of lower pressures in out-of-office settings, and 10/5 mm Hg was the most common adjustment factor used. Self-monitoring of blood pressure was widespread among the patients of responding GPs. Although the majority used appropriate schedules of measurement, some GPs suggested much more frequent home measurements than usual. Further, interpretation of home blood pressure was suboptimal, with only a minority recognising that values for diagnosis and on-treatment target are lower than those for clinic measurement. Subsequent national guidance may improve this situation but will require adequate implementation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. NICE. The Clinical Management of Primary Hypertension in Adults: Clinical Guideline 127.. London, UK, 2011.

  2. Bray EP, Holder R, Mant J, McManus RJ . Does self monitoring reduce blood pressure? Meta-analysis with meta regression of randomised controlled trials. Ann Med 2010; 42: 371–386.

    Article  Google Scholar 

  3. Joint Health Surveys U. Health Survey for England 2009. In: Craig R, Hirani V (eds) The Health and Social Care Information Centre: London, UK, 2009.

  4. McManus RJ, Glasziou P, Hayen A, Mant J, Padfield P, Potter J et al. Blood pressure self monitoring: questions and answers from a national conference. BMJ 2008; 337: a2732.

    Article  Google Scholar 

  5. Cuspidi C, Meani S, Lonati L, Fusi V, Magnaghi G, Garavelli G et al. Prevalence of home blood pressure measurement among selected hypertensive patients: results of a multicenter survey from six hospital outpatient hypertension clinics in Italy. Blood Press 2005; 14: 251–256.

    Article  Google Scholar 

  6. Viera AJ, Cohen LW, Mitchell CM, Sloane PD . How and why do patients use home blood pressure monitors? Blood Press Monit 2008; 13: 133–137.

    Article  Google Scholar 

  7. Tisler A, Dunai A, Keszei A, Fekete B, Othmane Tel H, Torzsa P et al. Primary-care physicians' views about the use of home/self blood pressure monitoring: nationwide survey in Hungary. J Hypertens 2006; 24: 1729–1735.

    Article  CAS  Google Scholar 

  8. Logan AG, Dunai A, McIsaac WJ, Irvine MJ, Tisler A . Attitudes of primary care physicians and their patients about home blood pressure monitoring in Ontario. J Hypertens 2008; 26: 446–452.

    Article  CAS  Google Scholar 

  9. Parati G, Stergiou GS, Asmar R, Bilo G, de Leeuw P, Imai Y et al. European Society of Hypertension Practice Guidelines for home blood pressure monitoring. J Hum Hypertens 2010; 24: 779–785.

    Article  CAS  Google Scholar 

  10. Baral-Grant S, Haque MS, Nouwen A, Greenfield SM, McManus RJ . Self-monitoring of blood pressure in hypertension: a UK primary care survey. Int J Hypertens 2012; 2012: 582068.

    Article  CAS  Google Scholar 

  11. Staessen JA, Den Hond E, Celis H, Fagard R, Keary L, Vandenhoven G et al. Antihypertensive treatment based on blood pressure measurement at home or in the physician’s office: a randomized controlled trial. JAMA 2004; 291: 955–964.

    Article  CAS  Google Scholar 

  12. NHS General Practice Workforce Bulletin 2010: The Information Centre for Health and Social Care 2011.

  13. McManus RJ, Ryan R, Jones M, Wilson S, Hobbs FR . How representative of primary care are research active practices? Cross-sectional survey. Fam Pract 2008; 25: 56–62.

    Article  Google Scholar 

  14. Hodgkinson J, Mant J, Martin U, Guo B, Hobbs FD, Deeks JJ et al. Relative effectiveness of clinic and home blood pressure monitoring compared with ambulatory blood pressure monitoring in diagnosis of hypertension: systematic review. BMJ 2011; 342: d3621.

    Article  CAS  Google Scholar 

  15. Jones MI, Greenfield SM, Bray EP, Baral-Grant S, Hobbs FD, Holder R et al. Patients’ experiences of self-monitoring blood pressure and self-titration of medication: the TASMINH2 trial qualitative study. Br J Gen Pract 2012; 62: e135.

    Article  Google Scholar 

  16. Ovaisi S, Ibison J, Leontowitsch M, Cloud G, Oakeshott P, Kerry S . Stroke patients’ perceptions of home blood pressure monitoring: a qualitative study. Br J Gen Pract 2011; 61: 604–610.

    Article  Google Scholar 

  17. McManus RJ, Mant J, Roalfe A, Oakes RA, Bryan S, Pattison HM et al. Targets and self monitoring in hypertension: randomised controlled trial and cost effectiveness analysis. BMJ 2005; 331: 493.

    Article  CAS  Google Scholar 

  18. McManus RJ, Mant J, Bray EP, Holder R, Jones MI, Greenfield S et al. Telemonitoring and self-management in the control of hypertension (TASMINH2): a randomised controlled trial. Lancet 2010; 376: 163–172.

    Article  Google Scholar 

  19. Parati G, Stergiou GS, Asmar R, Bilo G, de Leeuw P, Imai Y et al. European Society of Hypertension guidelines for blood pressure monitoring at home: a summary report of the Second International Consensus Conference on Home Blood Pressure Monitoring. J Hypertens 2008; 26: 1505–1526.

    Article  CAS  Google Scholar 

  20. Williams B, Poulter NR, Brown MJ, Davis M, McInnes GT, Potter JF et al. Guidelines for management of hypertension: report of the fourth working party of the British Hypertension Society, 2004-BHS IV. J Hum Hypertens 2004; 18: 139–185.

    Article  CAS  Google Scholar 

  21. Pickering TG, Miller NH, Ogedegbe G, Krakoff LR, Artinian NT, Goff D . Call to action on use and reimbursement for home blood pressure monitoring: a joint scientific statement from the American Heart Association, American Society Of Hypertension, and Preventive Cardiovascular Nurses Association. Hypertension 2008; 52: 10–29.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We thank Jackie Howarth from the British Hypertension Society for assisting with the pilot. RJM is supported by an NIHR Career Development Fellowship. FDRH is an NIHR senior investigator.

Author information

Authors and Affiliations

  1. Primary Care Health Sciences, Radcliffe Observatory Quarter, University of Oxford, Oxford, UK

    R J McManus, C Heneghan & F D R Hobbs

  2. Primary Care Clinical Sciences, University of Birmingham, Birmingham, UK

    S Wood & E P Bray

  3. Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia

    P Glasziou

  4. Screening and Test Evaluation Program, School of Public Health, University of Sydney, Sydney, New South Wales, Australia

    A Hayen

  5. Primary Care Unit, Institute of Public Health, University of Cambridge, Cambridge, UK

    J Mant

  6. School of Clinical Sciences and Community Health, College of Medicine and Veterinary Science, University of Edinburgh, Edinburgh, UK

    P Padfield

  7. Ageing & Stroke Medicine Section, Norwich Medical School, University of East Anglia, Norwich, UK

    J F Potter

Authors
  1. R J McManus
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S Wood
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. E P Bray
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. P Glasziou
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A Hayen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. C Heneghan
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. J Mant
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. P Padfield
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. J F Potter
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. F D R Hobbs
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to R J McManus.

Ethics declarations

Competing interests

RJM has received blood pressure monitors for research purposes from Omron and Lloyds Pharmacy. FDRH has received limited research support in terms of blood pressure devices from Microlife and BpTRU. The remaining authors declare no conflicts of interest.

Additional information

Disclaimer

This article presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research funding scheme (RP-PG-0407-10347) and part funded in addition by the British Hypertension Society. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

Supplementary Information accompanies this paper on the Journal of Human Hypertension website

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Cite this article

McManus, R., Wood, S., Bray, E. et al. Self-monitoring in hypertension: a web-based survey of primary care physicians. J Hum Hypertens 28, 123–127 (2014). https://doi.org/10.1038/jhh.2013.54

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jhh.2013.54

  • Springer Nature Limited

Keywords

This article is cited by

Search

Navigation