scholarly journals Factors Associated With Physician Recommendation of Home Blood Pressure Monitoring and Blood Pressure in the US Population

2020 ◽  
Vol 33 (9) ◽  
pp. 852-859 ◽  
Author(s):  
Olive Tang ◽  
Kathryn Foti ◽  
Edgar R Miller ◽  
Lawrence J Appel ◽  
Stephen P Juraschek
Keyword(s):  
Blood Pressure ◽  
Medication Adherence ◽  
Blood Pressure Monitoring ◽  
Home Blood Pressure ◽  
Home Blood Pressure Monitoring ◽  
Physician Recommendation ◽  
Pressure Monitoring ◽  
Factors Associated ◽  
Health And Nutrition ◽  
Hypertension Awareness

Abstract BACKGROUND Hypertension guidelines recommend home blood pressure monitoring (HBPM) to help achieve blood pressure (BP) control. We hypothesized that HBPM use with a physician recommendation would be associated with lower BP and greater medication adherence. METHODS We used data from 6,320 adults with hypertension in the National Health and Nutrition Examination Survey 2009–2014 to characterize the association of (i) provider recommendation for HBPM and (ii) HBPM use on 2 outcomes: measured BP (linear regression) and medication adherence (logistic regression). Provider recommendation, HBPM use, and medication use were self-reported. RESULTS Among adults with hypertension, 30.1% reported a physician recommendation for HBPM, among whom 82.0% reported using HBPM. Among those who did not report a physician recommendation for HBPM, 28.3% used HBPM. Factors associated with a physician recommendation were having health insurance, higher education attainment, hypertension awareness, and having a prescription for antihypertensive medication. Among those who reported receiving a physician recommendation, those who used HBPM had a mean BP that was 3.1/4.5 mm Hg lower than those who did not. Those who reported having a physician recommendation and using HBPM were more likely to report hypertension medication adherence (odds ratio 2.9; 95% confidence interval: 2.0, 4.4). CONCLUSIONS HBPM use was associated with lower BP and higher medication adherence. Use of HBPM was higher among those with a physician recommendation. These results support a role for physicians in counseling and partnering with patients on HBPM use for BP management.

Abstract 076: Factors Associated With Home Blood Pressure Monitoring Among US Adults: The National Health and Nutrition Examination Survey (NHANES), 2013-2014

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Joel C Marrs ◽  
Sarah L Anderson
Keyword(s):  
High School ◽  
Blood Pressure ◽  
National Health ◽  
Blood Pressure Monitoring ◽  
Home Blood Pressure ◽  
Home Blood Pressure Monitoring ◽  
High School Diploma ◽  
Nutrition Examination Survey ◽  
Pressure Monitoring ◽  
Health And Nutrition

Introduction: National prevalence data on home blood pressure monitoring (HBPM) has previously been reported from 2009-2010, but no recent data has been reported. Methods: This report is based on national-level, cross-sectional data for noninstitutionalized US adults aged ≥18 years (n = 6,113 participants) from the National Health and Nutrition Examination Survey (NHANES), 2013-2014. Results: Overall, 25.5% (1560 of 6113) of the adults engaged in HBPM monitoring in the 2013-2014 survey year. This is an increase from the previous NHANES 2009-2010 analysis reporting a 21.7% (1302 of 6001) rate. The frequency of HBPM increased with higher age, higher education level, having a partner, hypertensive, hypertensive aware, and hypertensive treated. Both SBP and DBP were higher in the HBPM group and were both statistically significant. The groups of hypertensive, hypertensive-aware, and hypertensive-treated patients all showed higher rates of HBPM use than nonuse. The frequency of HBPM monitoring in the categories of less than monthly, monthly, and weekly was reported at rates of 7.8% (476 of 6113), 6.6% (401 of 6113), and 11.2% (683 of 6113), respectively. These reported rates are consistent and slightly increased in the weekly HBPM reported use compared with the NHANEs 2009-2010 analysis (7.2% [432 of 6001], 6.6% [396 of 6001], and 7.9% [474 of 6001), respectively). Adjusting for covariables, those who were aware of, treated for, and had known hypertension were more likely to have a higher frequency of HBPM than the reference: unaware, untreated, and no known hypertension (odds ratio (OR) = 1.98; OR = 2.13; and OR = 1.64, respectively). Individuals with less than a high school diploma and having no partner were less likely to perform HBPM than the reference: high school graduate or greater and having a partner (OR = 0.73; OR = 0.65, respectively). Conclusions: Approximately 21.0% (1084 of 6113) of adults engaged in monthly or more frequent HBPM which is an increase from the reported 14.5%(870 of 6001) rate in the 2009-2010 analysis. Having hypertension, being aware of hypertension, and being treated for hypertension were associated with an increased frequency of HBPM. Having no partner and less than a high school diploma were associated with lower frequency of HBPM.

Abstract 13199: Home Blood Pressure Monitoring Among Us Adults Without Hypertension: How Do Existing Patient and Physician Behaviors Correspond to Current Recommendations?

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Kelsey B Bryant ◽  
Matthew B Green ◽  
Ian M Kronish ◽  
Yiyi Zhang ◽  
James Sheppard ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Patient Characteristics ◽  
Home Blood Pressure ◽  
Bp Algorithm ◽  
Masked Hypertension ◽  
Home Blood Pressure Monitoring ◽  
Pressure Monitoring ◽  
Health And Nutrition ◽  
Patient Use

Introduction: Home blood pressure monitoring (HBPM) is an option recommended by the 2017 ACC/AHA guidelines to confirm a hypertension diagnosis or identify masked hypertension. Using clinic BP and patient characteristics, the Predicting Out-of-Office BP in the Clinic (PROOF-BP) algorithm can be used to guide HBPM decisions. It is unknown how existing patient use and physician recommendations for HBPM align with current screening recommendations. Methods: We used the 2009-2014 National Health and Nutrition Examination Survey (NHANES) to identify US adults aged ≥20 years without hypertension or antihypertensive medication use. We identified those who would have been recommended to undergo HBPM by ACC/AHA guidelines as those with a mean BP 120-159/<100 mm Hg and by the PROOF-BP algorithm as those with a predicted out-of-office BP 125-134/75-84 mm Hg. We required individuals to have complete data needed for the PROOF-BP algorithm (demographics, BP, smoking, alcohol use, kidney disease) and reported HBPM actual/recommended use. All analyses were weighted to be representative of the US population. Results: We included 7,185 NHANES adults without hypertension; weighted mean (SE) age was 41.5 (0.3) years, 48% female, and mean BP 117.0 (0.3)/70.4 (0.3) mm Hg. Overall, 50.3% of adults without hypertension would have been recommended to undergo HBPM by ACC/AHA guidelines and 29.7% by PROOF-BP ( Table ). Only 13.3% of those recommended HBPM by ACC/AHA guidelines used or were told to use HBPM, compared to 11.5% of those not recommended screening. Similar results were seen among those recommended HBPM by PROOF-BP ( Table ). Conclusions: Our analysis shows that prior to 2017 guidelines, a substantial proportion of US adults may have had their hypertensive status misclassified due to a lack of HBPM or undergo unnecessary monitoring. These findings suggest an opportunity for clinicians and health systems to more clearly target HBPM to those who need it given guidelines currently in use.

Home Blood Pressure Monitoring Devices: Device Performance in an Alaska Native and American Indian Population

2021 ◽  
Vol 33 (7-8_suppl) ◽  
pp. 40S-50S
Author(s):  
Krista R. Schaefer ◽  
Amber L. Fyfe-Johnson ◽  
Carolyn J. Noonan ◽  
Michael R. Todd ◽  
Jason G. Umans ◽  
...  
Keyword(s):  
Blood Pressure ◽  
American Indian ◽  
Alaska Native ◽  
Blood Pressure Monitoring ◽  
Intraclass Correlation ◽  
Home Blood Pressure ◽  
Home Blood Pressure Monitoring ◽  
Pressure Monitoring ◽  
Calibration Models ◽  
American Indian People

Objectives: Home blood pressure monitoring (HBPM) is an important component of blood pressure (BP) management. We assessed performance of two HBPM devices among Alaska Native and American Indian people (ANAIs). Methods: We measured BP using Omron BP786 arm cuff, Omron BP654 wrist cuff, and Baum aneroid sphygmomanometer in 100 ANAIs. Performance was assessed with intraclass correlation, paired t-tests, and calibration models. Results: Compared to sphygmomanometer, average BP was higher for wrist cuff (systolic = 4.8 mmHg and diastolic = 3.6 mmHg) and varied for arm cuff (systolic = −1.5 mmHg and diastolic = 2.5 mmHg). Calibration increased performance from grade B to A for arm cuff and from D to B for wrist cuff. Calibration increased false negatives and decreased false positives. Discussion: The arm HBPM device is more accurate than the wrist cuff among ANAIs with hypertension. Most patients are willing to use the arm cuff when accuracy is discussed.

Sign in / Sign up

Export Citation Format

Share Document