Self monitoring study

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Self monitoring could help to lower blood pressure

People with high blood pressure who monitor at home and have greater involvement in their treatment can see greater falls in blood pressure than those receiving conventional care.

This is according to the TASMINH2 trial, the first large study to test telemonitoring and self-medicine adjustment, which was reported online in The Lancet on 8 July.

527 people with high blood pressure were randomly placed into two groups, an intervention and a control group. The intervention group were asked to attend two training sessions to learn how to use their blood pressure monitor, and how to transmit readings to the research team using a modem connected to the monitor and plugged into a normal telephone socket.

They made two self-measurements each morning with a 5-minute interval and a traffic light system was used to code the readings. Medicine-adjustment plans consisting of two changes or increases in medication were agreed between participants and their family doctor.

Patients in the control group followed their usual medication and were simply asked to attend for a review by their family doctor.

Within six months, the intervention group saw systolic blood pressure (top number) decrease by 12·9 mm Hg, which was 3.7mm Hg greater than the control group (9·2 mm Hg). After 12 months, the difference between groups was 5·4 mm Hg.

The authors say: “Self-management of hypertension resulted in significant and worthwhile reductions in blood pressure. These findings seem to be the result of an increase in the number of antihypertensive drugs prescribed according to a simple medicine adjustment plan. Thus, self-management represents an important new addition to the control of hypertension in primary care.”

They added: “Self-management will not be suitable for all patients. However, even if only 20% of individuals with hypertension self-managed, this proportion would still represent around 4% of the UK population—ie, more than 2 million individuals.”

What's the Blood Pressure Association's view?
Mike Rich, Executive Director of UK charity the Blood Pressure Association, said: “These initial trials are promising and suggest that this method has the potential to help some people better manage their blood pressure in the future.

“While this level of self-management won’t suit everyone, we at the Blood Pressure Association actively encourage home monitoring. Since high blood pressure is largely symptomless, home monitoring can really help people to feel more in control of their condition and because they can see the daily effects their medicines are having, they are more likely to continue taking them, a crucial factor in reducing strokes and heart attacks.”

References: Telemonitoring and self-management in the control of hypertension (TASMINH2): a randomised controlled trial, Richard J McManus, J Mant, E P Bray, R Holder, M I Jones, S Greenfield, B Kaambwa, M Banting, S Bryan, P Little, B Williams, F D R Hobbs. Online article The Lancet, 8 July 2010.

Why not have a look at the Blood Pressure Association's range of clinically validated home blood pressure monitors, including the Watch BP Home, which has a diagnosis setting ideal for people who may wish to gather reilable home readings to discuss with their GP.

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