AUTHOR=Rhee Moo-Yong , Munakata Masanori , Nah Deuk-Young , Kim Je Sang , Kim Hae-Young 

TITLE=Home blood pressure measurement for hypertension management in the real world: Do not just measure, but share with your physician

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1103216

DOI=10.3389/fcvm.2023.1103216

ISSN=2297-055X

ABSTRACT=<sec><title>Introduction</title><p>Studies of the effectiveness of home blood pressure (BP) measurement on the treatment of hypertension in the real world are sparse, and the results are controversial. There is an efficacy-effectiveness gap in the treatment of hypertension using home BP measurements. We aimed to investigate the effect of reporting home BP to physicians on ambulatory BP control as a factor contributing to the efficacy-effectiveness gap in treating patients with hypertension.</p></sec><sec><title>Methods</title><p>We recruited patients ≥20 years of age taking antihypertensive drugs. Office and 24-h ambulatory BP were measured. A questionnaire to the measurement of home BP was conducted. Participants were divided into an HBPM(−) group, home BP was not measured (<italic>n</italic> = 467); HBPM(+)-R(−) group, home BP was measured but not reported (<italic>n</italic> = 81); and HBPM(+)-R(+) group, home BP was measured and reported (<italic>n</italic> = 125).</p></sec><sec><title>Results</title><p>The HBPM(+)-R(+) group had significantly lower office systolic BP (SBP, <italic>p</italic> = 0.035), 24-h SBP (<italic>p</italic> = 0.009), and daytime SBP (<italic>p</italic> = 0.016) than the HBPM(−) group, and lower nighttime SBP (<italic>p</italic> = 0.005) and diastolic BP (DBP, <italic>p</italic> = 0.008) than the HBPM(+)-R(−) group. In the multivariate analysis, the differences in 24-h SBP, daytime SBP, and nighttime DBP remained significant. There was a significant difference between groups in the target achievement rate of 24-h SBP (<italic>p</italic> = 0.046), nighttime SBP (<italic>p</italic> = 0.021), and nighttime DBP (<italic>p</italic> = 0.023). The nighttime SBP and DBP target achievement rates in the HBPM(+)-R(+) group were higher than those in the HBPM(+)-R(−) group (<italic>p</italic> = 0.006 and 0.010, respectively). Among patients measuring home BP, the adjusted odds ratio for 24-h and nighttime BP target achievement in the HBPM(+)-R(+) group were 2.233 and 3.658, respectively.</p></sec><sec><title>Conclusion</title><p>Home BP measurements should be reported to the treating physician to effectively manage hypertension.</p></sec><sec><title>Clinical trial registration</title><p><ext-link ext-link-type="uri" xlink:href="https://clinicaltrials.gov" xmlns:xlink="http://www.w3.org/1999/xlink">https://clinicaltrials.gov</ext-link>, identifier NCT03868384.</p></sec>