Home Blood Pressure Monitoring for Treatment Titration
Titration of antihypertensives using self-monitored blood pressure is a prerequisite for a successful management strategy for hypertension that utilises self-monitoring appropriately. Initial trials in the area suggested that the use of self-monitored blood pressure might lead to suboptimal care due to increased clinic blood pressure and fewer medications. These trials were flawed by the use of equivalent blood pressure targets for both home and clinic blood pressure. More recent trials using average home blood pressure over several days as the basis for titration with standard lower targets (135/85 mmHg) have shown equivalent outcome in terms of end organ damage and lower clinic blood pressure measured objectively by research staff. Self-management, where patients self-titrate using self-monitored blood pressure readings, is also effective and cost-effective. Taken together, these results suggest that self-monitored blood pressure is appropriate to use and probably superior to clinic blood pressure for the titration of antihypertensives, whether by professionals or their patients.
KeywordsBlood pressure Monitoring Medication titration Self-management
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