Home blood pressure monitoring is better predictor of cardiovascular disease and target organ damage than office blood pressure: a systematic review and meta-analysis.
The available, albeit rare, evidence indicates the superiority of home- over office blood pressure monitoring (HBPM vs OBP) to predict cardiovascular (CV) outcomes. We performed a systematic review to update the efficacy of HBPM vs OBP as predictors of all-cause mortality, CV death, and target organ damage. Two reviewers independently performed the literature search in various databases. A meta-analysis with a fixed-effect model was conducted, and the heterogeneity and inconsistency indices were assessed. The search identified 291 articles, of which 10 were eligible for inclusion in the study, and five articles published in 2012 were included in the meta-analysis. A previous meta-analysis showed the superiority of HBPM over OBP to predict all-cause mortality, CV mortality, and CV events. The meta-analysis of articles published in 2012 identified that HBPM was also a better predictor of proteinuria than OBP. In conclusion, the results of our systematic review and meta-analysis confirm that HBPM is a better predictor of CV outcomes and target organ damage than OBP.
Division of Cardiology and the National Institute for Science and Technology for Health Technology Assessment (IATS/CNPq), Centro de Pesquisa Clínica, 5º andar, Hospital de Clínicas de Porto Alegre, R. Ramiro Barcellos, 2350, 90.035-903, Porto Alegre, RS, Brazil, scfuchs@terra.com.br.
Sandra C
SC
Fuchs
Renato G B de
RG
Mello
Felipe C
FC
Fuchs
D000368:Aged; D001794:Blood Pressure; D001795:Blood Pressure Determination; D018660:Blood Pressure Monitoring, Ambulatory; D002318:Cardiovascular Diseases / Q000503:physiopathology* / Q000517:prevention & control / Q000652:urine; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D009819:Office Visits; D010349:Patient Compliance; D011237:Predictive Value of Tests; D011507:Proteinuria / Q000175:diagnosis / Q000209:etiology