Self-blood pressure monitoring is associated with improved awareness, adherence, and attainment of target blood pressure goals: Prospective observational study of 7751 patients

Abstract

We investigated whether self-blood pressure monitoring (SBPM) can improve the control rate of blood pressure (BP), adherence of antihypertensive medications, and the awareness of the importance of BP control in hypertensive patients. A total of 7751 patients who visited the outpatient clinics of private and university hospitals in Korea were given automatic electronic BP monitors and were recommended to measure their BP daily at home for 3 months. Changes in office BP, attainment of target BP, adherence to taking antihypertensive drugs, and awareness of BP were compared before and after SBPM. Patients and physicians were surveyed on their perception of BP and SBPM. Mean BP significantly decreased from 142/88 to 129/80 mm Hg (P < .001), and attainment of the target BP increased from 32% to 59% (P < .001) after SBPM. Drug non-adherence, which was defined as patient's not taking medication days per week, decreased significantly from 0.86 days to 0.53 days (P < .001). The rate of awareness of the BP goal increased from 57% to 81% (P < .001). Patients estimated that their mean BP was 125/81 mm Hg, but their actual mean BP was 142/88 mm Hg. Awareness about the importance of SBPM increased from 90% to 98%. The rate of SBPM ≥ once per week further increased, from 34% to 96%. In conclusion, SBPM is associated with reduced BP, better BP control rate, greater drug adherence, and improved perception of BP by the patients.

Keywords: awareness; blood pressure; control; monitoring.

Figure 1

Reduction of BP after the 3‐mo program of SBPM

Figure 2

Attainment of target BP of both SBP <140 mm Hg and DBP <90 mm Hg for patients with no complications and SBP <130 mm Hg and DBP <80 for patients with complications before and after the 3‐mo SBPM

Figure 3

Changes in drug compliance before and after SBPM. Vertical axis indicates the rate of lessening (upper red part in bar) or skipping (lower blue part in bar) drug number/week. Number in each box indicates the rate of drug lessening or skipping rate, number/week