Study confirms home blood pressure monitoring more accurate, affordable

Study confirms home blood pressure monitoring more accurate, affordable

The National Institute for Health and Clinical Excellence (NICE) has released new guidelines that pertain to the monitoring of high blood pressure. Instead of adhering strictly to clinic based methods, ambulatory blood pressure monitoring (repeated measurements throughout a 24-hour period), has proven to be more accurate than clinic-based measurements and also is better for your wallet because it can be done from home instead of always in a care facility.

High blood pressure is a leading risk factor for heart disease and stroke worldwide and is the most common reason for a primary care consultation for a chronic disorder in the UK, with at least a quarter of adults suffering from hypertension.

Ambulatory blood pressure monitoring allows blood pressure to be intermittently monitored during sleep, and is useful to determine whether the patient's blood pressure falls at night compared to daytime values. A night time fall is normal. It correlates with relationship depth but other factors such as sleep quality, age, hypertensive status, marital status, and social network support.

Absence of a night time dip is associated with poorer health outcomes, including increased mortality in one recent study. In addition, nocturnal hypertension is associated with end organ damage and is a much better indicator than the daytime blood pressure reading.

Professor Richard McManus, of the University's Department of Primary Care Clinical Sciences, who co-authored the paper with Dr Sue Jowett, of the Health Economics Unit, University of Birmingham, said:

"This research shows that ambulatory blood pressure monitoring at the time of diagnosis of high blood pressure would allow better targeting of treatment and is cost saving. Ambulatory monitoring is already available in some general practices and we have shown that its widespread use would be better for both patients and the clinicians looking after them. Treatment with blood pressure lowering medication is usually lifelong and so it is worth getting the decision to start right in the first place."

This ambulatory method is believed to be able to reduce the white coat hypertension effect in which a patient's blood pressure is elevated during the examination process due to nervousness and anxiety caused by being in a clinical setting. Out-of-office measurements are highly recommended as an adjunct to office measurements by almost all hypertension organizations.

The study, which was funded by the National Institute for Health Research (NIHR) and NICE was a collaborative project involving institutions from across the UK, including researchers from NICE, Barts, the University of London and the Universities of Birmingham, Oxford, Cambridge and Leicester.

Using a hypothetical primary care population aged 40-plus, with a screening blood pressure measurement of greater than 140/90 mm Hg, the researchers compared three diagnostic strategies (further blood pressure monitoring in a clinic, monitoring at home and measurements using a mobile monitor) to assess lifetime costs, quality-adjusted life years and cost effectiveness.

The results showed that ambulatory monitoring was the most cost effective option to diagnose high blood pressure in men and women of all ages, and it saved money in all groups and resulted in more quality-adjusted life years for both sexes in the 50-plus age group.

The study concludes:

"Ambulatory monitoring as a diagnostic strategy for hypertension after an initial raised reading in the clinic would reduce misdiagnosis and save costs. Additional costs from ambulatory monitoring are counter-balanced by cost savings from better targeted treatments. Ambulatory monitoring is recommended for most patients before the start of hypertensive drugs."

How to Calibrate a Blood Pressure Cuff (Video Medical And Professional 2018).

Section Issues On Medicine: Medical practice