The role of home blood pressure measurement in managing hypertension: an evidence-based review

Journal of Human Hypertension (2002) 16, 469472

2002 Nature Publishing Group All rights reserved 0950-9240/02 $25.00www.nature.com/jhhORIGINAL ARTICLEThe role of home blood pressure

measurement in managing hypertension:

an evidence-based reviewJ RickerbyKing Edward Road Surgery, Northampton NN1 5LY, UKThis article reviews the current literature regarding the

role of home measurement of blood pressure (BP) in the

management of hypertension. Subjects with hypertension can use simple automated devices to measure their

own BP at home. The results can be accurate and

reliable, and because multiple readings allow a mean

value to be calculated, a better estimate of the underlying BP level is obtained. Home measurement of BP

gives results which are equivalent to the accepted gold

standard measure of ambulatory BP values, whilst

using a simpler and much less expensive technique

which is therefore more widely available. Both methods

are better than conventional office measurements inKeywords: treatment; home measurement; self measurementidentifying the true or underlying mean BP level and

identifying falsely raised levels or white coat hypertension. White coat hypertension confounds the treatment

of hypertension, but may not be entirely harmless.

Ambulatory BP is a better predictor of cardiovascular

prognosis than clinic BP. The use of home BP measurement as an equivalent, feasible, and (apparently) more

cost-effective technique to measure BP in hypertension,

should enable groups of patients with a poorer prognosis to be identified and their treatment adjusted in

order to improve their prognosis.Journal of Human Hypertension (2002) 16, 469472. doi:10.1038/sj.jhh.1001423IntroductionThe management of patients with hypertension consumes a great deal of time and effort and yet there

is evidence that it is both underdiagnosed and

undertreated.1,2 Paradoxically there is also evidence

that some patients are over treated because of spurious or white coat hypertension (WCH).3Blood pressure (BP) is usually monitored using

clinic measurements by a doctor or nurse. Such

measurements are however subject to a large variability, and a mean of several measurements is held

to be a more precise estimate of the underlying level

of BP.1Ambulatory measurement (ABP) is regarded as the

gold standard of measurement but in reality is

expensive and infrequently used. Ambulatory BP

levels are more closely correlated with long-term

outcomes in hypertension than clinic measurements.4Measurement of BP at home is increasingly popular with both subjects and doctors.5 Semi automatedCorrespondence: Dr J Rickerby,...