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Self-Management of Hypertension Effective in High-Risk Patients — Physician’s First Watch

Medical News |
August 27, 2014

Self-Management of Hypertension Effective in High-Risk Patients

By Kelly Young

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

Self-monitoring with self-titration of antihypertensive drugs is more successful than usual care in reducing blood pressure in high-risk patients, according to a JAMA study.

U.K. researchers randomized roughly 500 patients with an office blood pressure of at least 130/80 mm Hg and at least one other cardiovascular risk factor to either usual care or self-management. Self-management patients monitored their blood pressure at home, and when a certain number of readings were higher than 120/75 mm Hg, they sent a form to their physician to request a medication change.

At 12 months, mean systolic blood pressure was 9.2 mm Hg lower in the self-management group than in the usual-care group.

Thomas Schwenk with NEJM Journal Watch General Medicine comments: "Self-management and self-monitoring has been shown to be effective ... [but] its uptake in the U.S. has been minimal. Integrated health care systems would do well to take another look at it, including its use in high-risk patients, based on the results of this study."

Reader Comments (7)

abdulrahman altahan MD FAAN Riyadh

It is practical with certain devoted patients or caretaker. However, Cut off levels are quite low!

H ROBERT SILVESTEIN Physician, Cardiology, Preventive Medicine Center

It may seem like bragging, but this is VERY old practice at our Center. We have been doing such for 10 years plus (so long, I forget). BP Rx is increased, maintained, or held according to proper parameters. The Omron wrist BP cuff is used because of its accuracy & portability. NO conflict of interest. HRS, MD, FACC

ARNOLD CHONG Physician, Anesthesiology

Self monitoring/self dosage adjustment of hypertensive pts depend on education level/motivation/adherence. Initiation should begin after consultation with their physician.

DONALD HISLOP Physician, Family Medicine/General Practice, home Office

I teach BP management with pride and as the door to good health .

DONALD HISLOP Physician, Family Medicine/General Practice, home office

BP teaching by physicians needs is very rewarding.

KOLLAR JOZEF Other Healthcare Professional, Cardiology, Slovakia

The result of that Study is expected, correct and reasonable in people with minimally middle education. This I may say from own experiences- Hypertensive men better knows self-manage and self-titrate blood pressure through use of the antihypertensives.

PAUL APRIL Physician, Internal Medicine, home

What kind of instrument was used for BP's and what risk factors were considered?

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