title: Home blood pressure monitoring in hypertensive stroke patients: a prospective cohort study following a randomized controlled trial.
abstract: BACKGROUND
  We found little data on long-term home blood pressure monitoring in stroke patients.
  
  
  OBJECTIVE
  After completing a 12-month trial of home monitoring in hypertensive stroke patients, we investigated the following: 1. The proportion of 118 control patients offered a monitor at the end of the trial without nurse support who used it at least monthly after 6 months. 2. The proportion of 119 intervention patients continuing to use their monitor monthly after 18 months. 3. Possible predictors of monitoring weekly in the first month after receiving a monitor: age, gender, ethnicity, cognition, anxiety, disability, ability to monitor blood pressure unaided and smoking.
  
  
  METHODS
  Participants (mean age 71, 34% with disability and 21% from ethnic minorities) were surveyed 1 and/or 6 months after the trial ended by postal and/or telephone questionnaire.
  
  
  RESULTS
  Of 237 potential participants, 53 (22%) declined, 16 (6%) were lost and 9 (4%) died during follow-up. Overall, reported monthly use of the monitor without nurse support was 47% [54/114, 95% confidence interval (CI) 38.2-56.5] at 6 months and 50% (57/114, 95% CI 40.8-59.2) at 18 months. Participants who monitored weekly after 1 month were more likely than the remainder to have no disability [Rankin score ≤ 1; relative risk (RR) 1.2; 95% CI 1.0-1.5] and low anxiety levels (FEAR score = 0; RR 1.5; 95% CI 1.1-2.0).
  
  
  CONCLUSIONS
  Around half of hypertensive stroke patients offered a blood pressure monitor but no support continued to use it after 6 and 18 months. Monitoring in the first month was common in those who were not anxious or disabled.
authors: Division of Population Health Sciences and Education, St George's University of London, London SW17 0RE, UK.
authors: Shazia
authors: S
authors: Ovaisi
authors: Pippa
authors: P
authors: Oakeshott
authors: Sarah
authors: S
authors: Kerry
authors: Alice E
authors: AE
authors: Crabtree
authors: Gillian
authors: G
authors: Kyei
authors: Sally M
authors: SM
authors: Kerry
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods / Q000451:nursing / Q000706:statistics & numerical data; D015331:Cohort Studies; D003627:Data Interpretation, Statistical; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data; D010352:Patient Dropouts / Q000523:psychology / Q000706:statistics & numerical data; D010358:Patient Participation; D059017:Primary Care Nursing / Q000379:methods / Q000706:statistics & numerical data; D018570:Risk Assessment; D020521:Stroke / Q000150:complications*
keywords: Cohort study; home blood pressure monitoring; hypertension; primary care; stroke.