Abstract P204: Home Blood Pressure Monitoring: A Missed Opportunity?

Introduction: The 2017 American College of Cardiology and American Heart Association hypertension guidelines recommend self-measured and home blood pressure (BP) monitoring to confirm the diagnosis of hypertension, to titrate anti-hypertensives and to assess adherence to treatment. However, it is unclear to what extent is home blood pressure monitoring being optimally utilized in everyday clinical practice. Hypothesis: We hypothesized that our Internal Medicine resident clinic underutilizes home BP monitoring as part of the diagnosis and continued management of hypertension. Methods: We performed a retrospective chart review of patients with a history of hypertension patients seen for at our Internal Medicine resident clinic in New York City between July 2019 and September 2019. We examined all progress notes in this time frame for documentation of home BP cuff measurements or prescriptions for home BP monitors as well as patient comorbidities such as tobacco use, coronary artery disease, diabetes and hyperlipidemia. The chi-square test was performed to evaluate and compare guideline adherence between groups. Statistical significance was considered at p < 0.05. Results: A total of 282 patients (mean age: 59) met inclusion criteria, of which, 114 (40.1%) had progress notes discussing home BP monitoring. Of those currently monitoring BP at home, 75/175 female patients (42%) and 68/107 male patients (63%) were not prescribed either a BP cuff or mention of a plan for home BP monitoring (p=0.0007). There was no significant correlation for BP cuff prescriptions or implementation of a BP diary in terms of resident year level, ethnicity, diabetes, coronary artery disease, hyperlipidemia, smoking history. Conclusion: There is a discrepancy in our current practice to incorporate home BP monitoring as part of the comprehensive care of hypertension particularly among males and females. There is a possibility that females are being targeted more for home blood pressure due to the preventive emphasis of cardiovascular morbidity in females. Current interventions including physician and patient clinic education as well as utilization of pamphlets to targeted patients are underway to improve this often overlooked component of hypertension management.