Abstract
Background/Aims Randomized controlled trials provide evidence that home blood pressure monitoring (HBPM) leads to small but significant decreases in blood pressure (BP) in patients with hypertension (HTN). Less is known about use of HBPM in the general population with HTN and its effect on BP control.
Methods From May 2006 to December 2007 we attempted to contact all patients with a diagnosis of HTN from 10 primary care clinics in Western Washington (Group Health) to determine there eligibility and willingness to participate in a the Electronic Communications and Home Blood Pressure Monitoring Trial (e-BP). Patients were asked whether they took their BP at home. Patients with essential HTN willing to participate were invited to 2 screening visits to determine if they had uncontrolled BP and eligible for study participation. We describe here the relationship between HBPM and willingness to attend a screening visit, and for those who had a screening visit whether prior use of HBPM predicted BP control.
Results Of the 9298 patients sampled, 8840 (95.1%) were contacted, and 7268 (82.2% of contacted) answered the HBPM question, with 60.8% stating they used a HBPM. After excluding 2684 participants who did not meet study eligibility criteria, patients who were eligible but who refused to attend a screening visit (n=2,078) were more likely to use HBPM than those willing to attend the screening visit (n=2,506) (67.9% vs. 57.9%, P=<.001). Among patients with a BP measure at the first screening visit, those who reported using HBPM trended toward improved BP control (BP <140/90 mm Hg) compared to patients not using HBPM, however this was relationship was not statistically significant (53.2% vs. 50.5%, p=0.18).
Discussion Hypertensive patients who were not willing to participate in a study to use HBPM and Web communications to improve BP control were more likely to already use HBPM. Prior use of HBPM trended towards improved BP control, but not significantly. HBPM use by itself does not predict HTN control, possibly because people may use these for different reasons.
