Home blood pressure monitoring improves blood pressure control

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  • Evidence-Based Healthcare & Public Health (2005) 9, 121122

    pressure control

    significantly reduced blood pressure compared with usual monitoring in healthcare

    Further details

    Search strategy

    Studies were identified using MDatabase of Systematic RevieAssessment Database, NHS Economic Evaluation Database and TRIP database. The websites for the Centre

    ARTICLE IN PRESS

    www.elsevier.com/locate/ebhph

    $Abstracted from: Cappuccio FP, Kerry SM, Forbes L, Donald A. Blood pressure control by home monitoring: meta-analysis of1744-2249/$ - see front matter & 2005 Elsevier Ltd. All rights reserved.doi:10.1016/j.ehbc.2005.01.004

    randomised trials. BMJ 2004; 329:145.for Reviews and Dissemination, and the Agency for Healthcare Research and Quality, were also searched.Reference lists were searched by hand.

    Inclusion/exclusion criteria

    Eligible studies were randomised controlled trials comparing home self blood pressure monitoring (ormonitoring by a family member) with healthcare system monitoring in people with hypertension.Exclusions: studies that used ambulatory blood pressure monitoring.settings (see results table). Adjusting for publication bias reduced this difference(mean difference in systolic pressure: 2.2mmHg, 95%CI 0.9 to 5.3; mean differencein diastolic pressure: 1.9mmHg, 95%CI 0.6 to 3.2). At 1 year, the relative risk ofhaving blood pressure above the target was lower in people who were monitoringthemselves at home compared with people monitored in the healthcare system (RR0.9, 95%CI 0.8 to 1.0).Authors conclusions: Home blood pressure monitoring improves blood pressuremore than monitoring in the healthcare system in people with hypertension.& 2005 Elsevier Ltd. All rights reserved.

    EDLINE (1966 to January 2003), EMBASE (1980 to January 2003), Cochranews, Database of Abstracts of Clinical Effectiveness, Health TechnologyQuestion: Does home monitoring improve blood pressure control in people withhypertension?Study design: Systematic review with meta-analysis.Main results: Eighteen randomised controlled trials met inclusion criteria (13reported systolic blood pressure; 16 reported diastolic blood pressure; threereported mean arterial pressure; and six reported blood pressure above target).Blood pressure self-monitoring at home, or monitoring by a family member

    KEYWORDSBlood pressure;Home monitoring;HypertensionEVIDENCE-BASED HEALTHCARE MANAGEMENT

    Home blood pressure monitoring improves blood$

  • Data analysis

    Data were extracted on the change in systolic, diastolic and mean arterial blood pressure between people

    Authors note that effects of home monitoring may be underestimated due to heterogeneity in the design of

    Abstract provided by Bazian Ltd, London

    ARTICLE IN PRESS

    Results table

    Effect of home monitoring on blood pressure in people with hypertension.

    Outcome Home monitoring n healthcare system monitoringMean difference (mmHg) 95% CI

    Systolic blood pressure 4.2 1.5 to 6.9Diastolic blood pressure 2.4 1.2 to 3.5Mean arterial blood pressure 4.4 2.0 to 6.8

    EVIDENCE-BASED HEALTHCARE MANAGEMENT122the eligible studies.

    Sources of funding: Bristol-Myers Squibb, UK.who were monitoring blood pressure at home and people who were being monitored in the healthcaresystem. Information was also extracted on the number of people above the target blood pressure. Meta-analysis was carried out using a random effects model and publication bias was examined using funnel plotanalysis.

    Main outcomes

    Change in blood pressure; change in proportion of people with blood pressure above target.

    Notes

    Home blood pressure monitoring improves blood pressure controlFurther detailsSearch strategy

    Inclusion/exclusion criteriaData analysisMain outcomesResults table

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