Use of home blood-pressure monitoring in the detection, treatment and surveillance of hypertension.
OBJECTIVE
Use of home blood-pressure monitoring is increasing but the technique and the equipment have limitations. We provide an overview of recent evidence in this rapidly evolving field.


RESULTS
Home blood-pressure monitoring is an acceptable method for screening patients for hypertension. There is increasing evidence supporting the predictive power of home blood pressure for stroke risk even in the general population. The identification of white-coat and masked hypertension remains an important role for home blood-pressure monitoring. Unvalidated equipment and poor patient technique are major concerns. The purchase of devices needs to be linked to a simple patient-education programme, which is perhaps an opportunity for collaboration between healthcare providers and commercial companies. Devices that store the blood-pressure measurements in the memory are preferred to ensure accuracy of reporting. Data-transmission systems providing automatic storage, transmission and reporting of blood pressure, direct involvement of the patient and potentially a reduced number of hospital/general practitioner visits, offer significant advantages. To reduce patient anxiety, overuse of home blood-pressure monitoring should be avoided but there is the potential for self-modification of treatment, subject to certain safeguards.


CONCLUSIONS
Self-monitoring of blood pressure is developing rapidly, linked to increasing awareness of the impact of reducing high blood pressure on public health and the marketing/advertising strategies used to sell automatic devices. Home blood-pressure monitoring has a role in the detection and management of blood pressure, but not at the expense of careful blood-pressure measurement in the office and adherence to national guidelines.
Manning
Gillian
G
School of Medical & Surgical Sciences, University of Nottingham, Nottingham, and Derby Hospitals NHS Foundation Trust, Derby, UK. Gillian.manning@nottingham.ac.uk
Donnelly
Richard
R
D001795:Blood Pressure Determination / Q000379:methods*; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000188:drug therapy; D010353:Patient Education as Topic