Telemonitoring, Self-Titration Tied to Lower Blood Pressure

Patients who manage own drugs, monitor own BP have greater BP drops than those in usual care
By Monica Smith
HealthDay Reporter

THURSDAY, July 8 (HealthDay News) -- Patients who self-manage their antihypertensive medication and engage in telemonitoring of their blood pressure (BP) measurements appear to fare better than patients who receive conventional treatment for hypertension, according to a study published online July 8 in The Lancet.

Richard J. McManus, of the University of Birmingham in the United Kingdom, and colleagues randomly assigned 527 patients who, despite antihypertensive treatment, still had BP above 140/90 mm Hg to self-management (self-monitoring of BP, self-administration of antihypertensive medication, and telemonitoring of home BP measurements) or usual care.

The researchers found that, in the 234 self-management participants included in the primary analysis, mean systolic BP decreased by 12.9 mm Hg within six months, versus a decline of 9.2 mm Hg in the 246 control participants in the analysis; within 12 months, mean systolic BP in the self-management group dropped 17.6 mm Hg, compared with 12.2 mm Hg in the control group. The rate of most side effects was the same for the two groups, except for leg swelling, which occurred in 74 self-management participants (32 percent) and 55 controls (22 percent).

"Self-management of hypertension resulted in significant and worthwhile reductions in BP that were maintained at six months and 12 months compared with usual care. These findings seem to be the result of an increase in the number of antihypertensive drugs prescribed according to a simple titration plan. Thus, self-management represents an important new addition to the control of hypertension in primary care," the authors write.

McManus has received a fee from Tplus Medical to advise on telemonitoring services, and a co-author has received research support (BP devices) from Microlife and pTRU.

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