HOME BLOOD PRESSURE MONITORING (HBPM) IN CLINICAL PRACTICE: A SYSTEMATIC REVIEW AND EXPERIENCE REPORT OF ONLINE TOLL FOR RESULTS REPORT IN BRAZIL

Abstract

Objective: Perform a systematic review of systemic arterial hypertension (SAH) diagnosis and follow-up using home blood pressure monitoring (HBPM) and report the experience of using an online tool (TeleMRPAÔ) for results report in Brazil. Design and method: The MedlineÔ, EmbaseÔ, and Cochrane LibraryÔ databases were searched for randomized studies on the effectiveness of the monitoring and diagnosis of SAH with HBPM from 2014 to 2018. The keywords used were hypertension, blood pressure, home blood pressure monitoring. A full review of 132 articles was performed and 36 studies were considered potentially eligible. Out of the 36 potentially eligible studies, 25 studies were published from 2014 to 2018, conducted in North America and Europe and included a wide variety of hypertension assessment methods. Only 10 studies aimed to analyze HBPM as a tool for the diagnosis and / or follow-up of SAH. TeleMRPAâ is an online tool (www.telemrpa.com) developed in Brazil to facilitate HBPM results reporting by cardiologists. Through this tool, it is possible to standardize the report and, from the data entered online, it is possible to generate a final report that gives greater feasibility, reproducibility of the method, minimizing errors. Results: The regular use of HBPM decreases the rates of cardiovascular events and SAH related mortality, as well as lower health care costs when compared to the monitoring of SAH only with office measurements. There was a consonance of the studies indicating a low sensitivity of the blood pressure measurement in the office to detect the optimal control of SAH when compared to the addition of HBPM. Thus, TeleMRPAâ made it possible for HBPM to be extended to more cardiologists and their patients. Conclusions: The use of HBPM showed to be effective. The HBPM should be included in the diagnosis and follow-up of SAH more routinely. Still, HBPM encourages the increase of patient participation in their self-care, as it reinforces patient-centered care, improving SAH control. In addition, in Brazil, the TeleMRPAâ has made SAH monitoring more comprehensive.