scholarly journals Uncontrolled hypertension based on morning and evening home blood pressure measurements from the J-HOME study

2009 ◽  
Vol 32 (12) ◽  
pp. 1072-1078 ◽  
Author(s):  
Taku Obara ◽  
◽  
Kie Ito ◽  
Takayoshi Ohkubo ◽  
Taku Shibamiya ◽  
...  
2008 ◽  
Vol 22 (3) ◽  
pp. 197-204 ◽  
Author(s):  
T Obara ◽  
◽  
T Ohkubo ◽  
K Asayama ◽  
H Metoki ◽  
...  

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Karen L Margolis ◽  
Stephen E Asche ◽  
Anna R Bergdall ◽  
Steven P Dehmer ◽  
Beverly B Green ◽  
...  

Background/Aims: Hypertension is a common condition and leading cause of cardiovascular disease. We previously reported results of a cluster-randomized trial evaluating a home blood pressure (BP) telemonitoring and pharmacist management intervention, with significant reductions in BP favoring the intervention arm over 18 months. This analysis examined the durability of the intervention effect on BP through 54 months of follow-up and compared BP measurements performed in the research clinic and in routine clinical care. Methods: The Hyperlink trial randomized 16 primary care clinics having 450 study-enrolled patients with uncontrolled hypertension to either Telemonitoring Intervention (TI) or usual care (UC) study arms. BP was measured as the mean of 3 measurements obtained at each research clinic visit. General linear mixed models utilizing a direct likelihood-based ignorable approach for missing data were used to examine change from baseline to 54 months in systolic and diastolic BP (SBP and DBP). Results: Research clinic BP measurements were obtained from 326 (72%) study patients at the 54 month follow-up visit. Routine clinical care BP measurements were obtained from 444 (99%) of study patients from 7025 visits during the follow-up period. For TI patients, based on research clinic measurements baseline SBP was 148.2 mm Hg and 54 month follow-up was 131.2 mm Hg (-17.0 mm Hg, p<.001). For UC patients, baseline SBP was 147.7 mm Hg and 54 month follow-up was 131.7 mm Hg ( -16.0 mm Hg, p<.001). The differential reduction by study arm in SBP from baseline to 54 months was -1.0 mm Hg (95% CI: -5.4 to 3.4, p=0.63). For TI patients, baseline DBP was 84.4 mm Hg and 54 month follow-up was 77.8 (-6.6 mm Hg, p<.001). For UC patients, baseline DBP was 85.1 mm Hg and 54 month follow-up was 79.1 mm Hg (-6.0 mm Hg, p<.001). The differential reduction by study arm in DBP from baseline to 54 months was -0.6 mm Hg (95% CI: -3.5 to 2.4, p=0.67). SBP and DBP results from routine clinical measurements closely approximated the pattern of results from research clinic measurements. Conclusion: Significant BP reductions in the TI arm relative to UC were no longer seen at 54 month follow-up. To maintain intervention benefits over a longer period of time additional intervention is needed.


2019 ◽  
Vol 37 (5) ◽  
pp. 923-927 ◽  
Author(s):  
Antoine Cremer ◽  
Anne-laure Rousseau ◽  
Romain Boulestreau ◽  
Sophie Kuntz ◽  
Christophe Tzourio ◽  
...  

2018 ◽  
Vol 4 (2) ◽  
pp. 84-90
Author(s):  
Gavin Devereux ◽  
Daniel Gibney ◽  
Fiqry Fadhlillah ◽  
Paul Brown ◽  
Neil Macey ◽  
...  

BackgroundKey benefits of home-based blood pressure measurements are the potential to reduce the risk of ‘white coat hypertension’, encouraging patients to take ownership of their condition and be more actively involved in their long-term condition care, and to move work out of the doctor’s office.AimTo assess whether performing 20 resting blood pressure measurements over a 2-day period would provide a reliable, stable representation of patients’ resting systolic and diastolic blood pressure. Following clinician recommendation, each participant completed the Stowhealth home blood pressure monitoring procedure.MethodOne thousand and forty-five participants (mean age 66±13 years, 531 women and 514 men) completed the procedure, of 10 resting measurements per day, for 2 days (20 resting systolic and diastolic blood pressure readings in total). All measurements were made using automated oscillometric monitors.ResultsWithin-patient coefficient of variation for the entire participant cohort was 8% for systolic blood pressure (cohort mean 141±11 mm Hg), and 8% for diastolic blood pressure (cohort mean 79±6 mm Hg). There were no significant differences between the first and second day, for either systolic (142±1vs 141±1 mm Hg, respectively, p>0.05) or diastolic blood pressures (79±1vs 78±1 mm Hg, respectively, p>0.05 in both cases).ConclusionThe overall duration of home blood pressure monitoring may be able to be reduced to just 48 hours. This method would offer meaningful time saving for patients, and financial and time benefits for doctors and their surgery administration.


Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
Elizabeth H Kim ◽  
Eric Luong ◽  
Trevor Trung Nguyen ◽  
Sandy Castillo ◽  
Joseph E Ebinger ◽  
...  

Background: Home blood pressure monitoring (HBPM) devices can now be linked to electronic health records (EHR) systems in ways that could be used to facilitate blood pressure (BP) management; however, their potential feasibility and utility remain unclear. Methods: For our pilot study, we identified N=5 outpatients with uncontrolled hypertension and implemented use of a HBPM device with frequent monitoring and direct linkage to the EHR, whereby real-time data was made available to treating providers. We matched our intervention patients by age and sex with N=50 patients who also had uncontrolled hypertension and underwent standard-of-care treatment. We assessed change over time in BP measures for the intervention and standard-of-care groups. Results: In analyses accounting for differences in the timing and frequency of BP measurements, we observed that the intervention compared to the standard-of-care group had an average systolic BP at 8 weeks that was lower in percent change from baseline (β=-22 mm Hg, P=0.008). We also found a difference between baseline and 8-week systolic BP within the intervention group (mean difference -25.9 mm Hg, P=0.024). Conclusions: In our pilot, intensive remote HBPM appeared to improve BP levels over the short term. While unblinded and not controlled for factors beyond age and sex, this pilot demonstrates feasibility of an EHR-linked HBPM intervention and potential efficacy that may be related to increased patient as well as provider awareness translating to greater patient-provider engagement around hypertension management. More studies are needed to validate and expand from our findings.


2018 ◽  
Vol 36 ◽  
pp. e219-e220
Author(s):  
Beh Hooi Chin ◽  
Hooi Chin Beh ◽  
Siew Mooi Ching ◽  
Navin Kumar ◽  
Yook Chin Chia

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