Home blood pressure monitoring improves blood pressure control

Abstract

QuestionDoes home monitoring improve blood pressure control in people with hypertension?Study designSystematic review with meta-analysis.Main resultsEighteen randomised controlled trials met inclusion criteria (13 reported systolic blood pressure; 16 reported diastolic blood pressure; three reported mean arterial pressure; and six reported blood pressure above target). Blood pressure self-monitoring at home, or monitoring by a family member significantly reduced blood pressure compared with usual monitoring in healthcare settings (see results table). Adjusting for publication bias reduced this difference (mean difference in systolic pressure: 2.2 mmHg, 95%CI −0.9 to 5.3; mean difference in diastolic pressure: 1.9 mmHg, 95%CI 0.6 to 3.2). At 1 year, the relative risk of having blood pressure above the target was lower in people who were monitoring themselves at home compared with people monitored in the healthcare system (RR 0.9, 95%CI 0.8 to 1.0).Authors’ conclusionsHome blood pressure monitoring improves blood pressure more than monitoring in the healthcare system in people with hypertension.