Are home blood pressure devices accurate? A systematic review of the evidence

Abstract

controlled apparent treatment resistant hypertension (BP < 140/90 mmHg on 4 antihypertensive medications, aTRH, n1⁄4547) and uncontrolled aTRH (BP 140/90 mmHg on 3 antihypertensive medications, n1⁄41,288). At baseline, the prevalence of beta-blocker use was 96.9% and 71.1% among controlled aTRH and uncontrolled aTRH groups respectively. Whereas, the prevalence of beta-blocker use was 35.3% and 18.2% among controlled HTN and uncontrolled HTN groups respectively. AF prevalence ratios were estimated with normotension as a reference group, and full multi-variable adjustment included demographics, cardiovascular risk factors and antihypertensive medication classes. In fully adjusted model as shown in the table, the prevalence of AF among normotensive and prehypertension group were similar. Compared to normotensive persons the prevalence of AF was higher across all categories of HTN. However, the AF prevalence was almost similar among controlled HTN, uncontrolled HTN and uncontrolled aTRH (Prevalence ratios: 1.42, 1.36 and 1.41 respectively). Among antihypertensivemedications, beta-blockers had the greatest impact on AF prevalence. Therefore, AF prevalence ratio of 1.17 in controlled aTRH group may probably be linked to the highest prevalence of beta-blocker use compared to other groups. The current study findings indicate that antihypertensive medications have substantial impact on AF prevalence. The prevalence of AF is similar among persons with HTN regardless of BP control and antihypertensive treatment resistance.