S-56-2: HOME BLOOD PRESSURE MEASUREMENT FOR HYPERTENSION MANAGEMENT IN THE REAL WORLD: THE IMPORTANCE OF REPORTING HOME BLOOD PRESSURE TO DOCTORS

Abstract

Introduction: Most studies that sought the effect of home blood pressure (HBP) measurements were conducted in controlled conditions or by measuring office BP. We investigated the effects of HBP measurements on the management of hypertension in the real world, through measurement of ambulatory BP. Methods: Patients taking antihypertensive drugs (>1 year) and > = 20 years of age were recruited. A survey asking the duration and frequency of HBP measurements if the participants reported their HBP results to their clinicians was conducted. The patients were divided into (1) HBPM(-) group: HBP was not measured (n = 467), (2) HBPM(+)UR group: HBP was measured but not reported (n = 81), and (3) RHBPM(+)R group: HBP was measured and reported (n = 125). Results: The HBPM(+)R group had lower office systolic blood pressure (SBP, 125.8 ± 9.9 vs 128.5 ± 11.4 mmHg, p = 0.035), 24-hour SBP (121.0 ± 9.8 vs 124.1 ± 11.2 mmHg, p = 0.009), and daytime SBP (122.7 ± 10.9 vs 125.9 ± 12.2 mmHg, p = 0.017) than the HBPM(-) group, and lower nighttime SBP (114.8 ± 11.8 vs 119.9 ± 10.8, p = 0.005) and diastolic blood pressure (DBP, 72.6 ± 9.0 vs 76.6 ± 8.4 mmHg, p = 0.008) than the HBPM(+)UR group. In the multivariate analysis, the difference in 24-hour and daytime SBP and nighttime DBP remained significant. There was a significant difference between groups in regard to the control of office DBP [70.6% for HBPM(+)R, 60.4% for HBPM(-), and 55.0% for HBPM(+)UR groups; p = 0.047]; 24-hour SBP (68.3%, 57.0% and 53.1%, respectively; p = 0.046), nighttime SBP (36.7%, 31.2% and 18.5%, respectively; p = 0.021) and nighttime DBP (20.8%, 19.8% and 7.4%, respectively; p = 0.023). Nighttime SBP and DBP control rate of the HBPM(+)R group were higher than those of HBPM(+)UR group (p = 0.007 and 0.010). Among the patients measuring home BP, the adjusted odds ratio for 24-hour and nighttime BP control in the HBPM(+)R group were 2.176 (95%CI, 1.010–4.687) and 36.651 (95%CI, 1.110–12.005), respectively, compared to the HBPM(+)UR group. Conclusion: This study shows that patients with hypertension should not only take HBP measurements but also report these to the treating clinician for appropriate management of hypertension.