Does Self-measurement of Blood Pressure (SMBP) Contribute to Improve the Degree of Hypertension Control?

Abstract

Background and objectives: Self-measurement of blood pressure can be associated with a better control of blood pressure. The objectives of this study were to determine the degree of control with two measuring methods (clinical blood pressure measure and self-measurement of blood pressure) and determine the factors associated with poor control. Methods: Multicenter randomized cross-sectional Study in Hypertensive patients diagnosed and treated at Primary Care. Recollected data included: socio-demographic profiles, personal history, standard blood tests and arterial pressure measure by self-measurement of blood pressure and clinical blood pressure measure. Control objectives included for self-measurement of blood pressure (<135/85 mmHg) and for clinical blood pressure measure (<140/90 mmHg). Data are expressed in percentages and averages with a CI of 95%. Results: 514 patients where included (59.3% female) with a mean age of 70.84 (80.01-61.67) years old and 10.37 (14.87-5.62) years of hypertensive disease evolution. The degree of control was 84.67% (83.58-85.76) with self-measurement of blood pressure and 68.54% (67.31-69.77); p<0.0001. Patients controlled by self-measurement of blood pressure took 2.58 (1.65-3.51) versus 2.97 (2.11-3.83) with clinical blood pressure measure; p<0.001. Being more frequent the use of fixed combinations. Obesity, diabetes, hyperlipidemia, cardiovascular disease, severity of hypertension, measurement method, number of drugs and age were associated with poorer control of the blood pressure; p<0.001. Conclusions: The degree of control with self-measurement of blood pressure is very high, compared with ambulatory monitoring, with important clinical significance. Although the characteristics of this study can not infer causality, this finding reinforces the recommendations of the Clinical Practice Guidelines for the regularly use of the self-measurement of blood pressure in our daily practice.