Hypertensive patients are more likely to use a blood pressure cuff at home to measure blood pressure
According to new data presented at the American Heart Association's 2021 Hypertension Scientific Sessions, adults would rather monitor their blood pressure at home than go to a clinic for an in-person blood pressure measurement or monitor it via a remote wearable device. Research presented at the AHA 2021 Hypertension Scientific Sessions offers important recommendations for healthcare practitioners on how best to document high blood pressure to confirm a diagnosis. And this is a key sticking point for the industry right now.
According to the American Heart Association, about one in two adults in the United States has high blood pressure, but not all of them know they have it. To complicate matters, diagnosing high blood pressure can be tricky. Most hospital clinics diagnose high blood pressure based on blood pressure readings taken in the hospital or clinic. In other words, the data they get may often be measured by a patient in a high-pressure environment, which can lead to skewed readings.
Green, a senior researcher from Seattle, said in a public statement that although the U.S. Preventive Services Task Force and the American Heart Association recommend blood pressure measurements outside the clinical setting to diagnose high blood pressure before initiating treatment, large Most high blood pressure is diagnosed and treated based on blood pressure measurements in a doctor's office. He added in the statement that blood pressure monitoring using home blood pressure monitoring or 24-hour ambulatory blood pressure monitoring should be a standard practice before hypertension is diagnosed.
At the same time, the researchers acknowledged that although 24-hour ambulatory monitoring is often referred to as the gold standard for chronic disease diagnosis, a survey of 510 patients showed that wearing a blood pressure monitor continuously is not as practical as using a home monitoring device. Patients rated a home monitoring device, a blood pressure cuff that they use daily in their home, as superior to nearly all other blood pressure checks.
Green and his team divided participants into three groups for the trial -- routine clinic care that required an additional blood pressure check; home monitoring with a blood pressure cuff, which involved teaching patients how to use an oximeter and asking patients to take a five-day test. of twice-daily measurements; there was also a kiosk group who needed to take their blood pressure nine times a day over 3 days at a kiosk in a clinic or nearby pharmacy. At the same time, each group of patients also used wearable devices for 24-hour ambulatory blood pressure monitoring.
The researchers found that the home monitoring strategy was the most successful, as patients found it easier to implement and more satisfying to use. Acceptability was highest measured in households, followed by clinic visits, and then pharmacy terminals. And 24-hour wearable device monitoring has the lowest satisfaction. Monitoring at home is also the most persistent method for patients, with about 90% of patients being able to adhere to home measurement. This compares with 87% in the clinic group and 68% in the terminal group. Adherence to 24-hour ambulatory blood pressure monitoring was also high, at 91%. However, the user experience is not very good, and patients are not very satisfied with such monitoring. This is a challenge for ambulatory blood pressure monitoring.
All told, more than half of the study participants said they would choose home monitoring with a blood pressure cuff if given the choice. This includes 80% of those who participated in the home monitoring study group. Researcher Green pointed out that this may be because the method is very easy to implement and use. Home blood pressure monitoring is the most popular choice because it is convenient, easy to operate, does not interfere too much with their daily personal or work schedule, and is considered accurate by such measurements. Ambulatory blood pressure monitoring disrupts daily and work activities, disrupts sleep and is uncomfortable to wear.
These findings should help shape the diagnosis and management of chronic diseases. Healthcare practitioners should provide home monitoring with blood pressure cuffs so that patients can adhere to blood pressure measurements to improve diagnostic capabilities and patient satisfaction. At the same time, healthcare professionals should work to reduce reliance on clinic visits to diagnose hypertension and support patients in taking blood pressure measurements at home. Home blood pressure monitoring is enhancing and improving our ability to identify and treat high blood pressure and prevent stroke, heart attack, heart failure and cardiovascular death.
The AHA acknowledges that ensuring access to blood pressure cuff resources and patient use training will be a critical part of this effort. As part of their efforts to achieve health equity, the AHA noted that they plan to use community health partnerships to improve patient awareness of blood pressure and access to resources such as blood pressure cuffs, allowing all patients to receive care at home.