MeSH Measurements can be read by a person or provided digitally by a device. b W 35D43zi&J &lbP K 7X Europe PMC is an archive of life sciences journal literature. Unauthorized use of these marks is strictly prohibited. Given clinical heterogeneity and limited head to head comparisons, the evidence limits our ability to draw definitive conclusions about the incremental effect of any specific additional support. pressure monitoring and refers to the regular use of a Telephone: (301) 427-1364, Effectiveness of Self-Measured Blood Pressure Monitoring in Adults With Hypertension, https://www.ahrq.gov/evidencenow/heart-health/blood-pressure/smbp-effectiveness.html, AHRQ Publishing and Communications Guidelines, Evidence-based Practice Center (EPC) Reports, Healthcare Cost and Utilization Project (HCUP), AHRQ Quality Indicator Tools for Data Analytics, United States Health Information Knowledgebase (USHIK), AHRQ Informed Consent & Authorization Toolkit for Minimal Risk Research, Grant Application, Review & Award Process, Study Sections for Scientific Peer Review, Getting Recognition for Your AHRQ-Funded Study, AHRQ Research Summit on Diagnostic Safety, AHRQ Research Summit on Learning Health Systems, National Action Alliance To Advance Patient Safety, Blood Pressure Control Evidence and Resources, Cholesterol Management Evidence and Resources, Advancing Heart Health Research and Results, U.S. Department of Health & Human Services. This includes encouraging the purchase of fully automated, validated home blood pressure monitors with a properly sized arm cuff, training patients in SMBP techniques, checking patients' measurement techniques for accuracy, and interpreting and providing counseling based on shared blood pressure readings. PMC The health care professional then inflates the cuff, which gently tightens on your arm. Bethesda, MD 20894, Web Policies Take at least two readings, 1 or 2 minutes apart. For SMBP plus additional support versus usual care, the strength of evidence is high and supports a lower BP with SMBP use (SBP/DBP -3.4 to -8.9/-1.9 to -4.4 mmHg) up to 12 months. Resource title: Effectiveness of Self-Measured Blood Pressure Monitoring in Adults With Hypertension Resource description: This research summary of a systematic review compares the effectiveness of various methods and approaches to blood pressure measurement by patients or companions. In response, providers offer customized support and advice, such as medication or lifestyle adjustments. hbbd```b``A$ug`rX|" o/XDLHp0{W$5)"30^` w However, there is uncertainty about the appropriate home BP targets for guiding treatment decisions and whether these should be based on the same cut-points from clinic BP or from ABPM for defining hypertension.32. Purpose Uhlig K, Balk EM, Patel K, et al. There are also a variety of kiosks available in stores and pharmacies. Measurements may interfere with a patient's activity or sleep. Public Information from the CDC and Medscape. Figure 2. This patient-friendly video from NACHC outlines clear instructions for using home blood pressure monitors. Together we can empower patients to take control of their hypertension, thereby reducing their risk for heart attack and stroke. sX Ndb`T~ The trials were greatly heterogeneous, varying in population, intervention, and outcome measures and definitions. All information these cookies collect is aggregated and therefore anonymous. This review does not explore the validity, reproducibility, or comparability of BP measurements across devices or techniques (which was addressed by the 2002 EPC report25), or the use of SMBP as a diagnostic tool. SMBP monitoring is the regular measurement of blood pressure by the patient outside the clinical setting, either at home or elsewhere. Your feet should be flat on the floor and your legs . official website and that any information you provide is encrypted government site. This report focuses on SMBP monitoring as a strategy to help patients and clinicians to better manage and control hypertension while avoiding under- or overtreatment or treatment-related hypotension. First, a health care professional wraps an inflatable cuff around your arm. These include ambulatory BP monitoring (ABPM), self monitoring (or self measurement or home based) BP which is usually done by the patient at home, at work, or in any conducive environment. Newer SMBP devices can automatically store readings and some are equipped to electronically transmit readings to a provider. Content last reviewed August 2018. The trials were greatly heterogeneous, varying in population, intervention, and outcome measures and definitions. and transmitted securely. Hypertension often requires lifelong treatment. Self-measured blood pressure monitoring (SMBP), the regular measurement of blood pressure by a patient outside the clinical setting, plus additional support, is a proven, cost-effective but underutilized strategy to improve hypertension outcomes. How does adherence with SMBP monitoring vary by patient factors? In studies of SMBP monitoring, how do clinical, surrogate, and intermediate outcomes (including SMBP monitoring adherence) vary by the type of additional support provided? : 14-05204-EF-1. Before Past forum recordings, slides, and other resources can be found on the SMBP ForumConfluence page. Show details Contents < Prev Next > Key Informants Susan Booth Project Leader, Personal Care & Wellness Consumer Reports Yonkers, NY Hayden Bosworth, Ph.D. In people with hypertension (adults and children), does self-measured blood pressure (SMBP) monitoring, compared with usual care or other interventions without SMBP, have an effect on clinically important outcomes? Self-measured blood pressure (SMBP) monitoring, the regular measurement of blood pressure (BP) by the patient at home, has been proposed as a means of improving treatment adherence and BP control. Ann Intern Med. Many SMBP devices are commercially available. SMBP measurements can be obtained from the upper arm, wrist, or fingers (or, if necessary, the lower extremity); however, experts recommend the use of upper arm devices due to the lack of validation and the high number of inaccurate measurements from the wrist and finger devices.26-28 Models for SMBP devices range from mechanical aneroid gauges (sphygmomanometers), which require self-inflation and auscultation (manual devices), to manually-inflated sphygmomanometers with automatic displays (semiautomated devices), to fully automated configurations that automatically inflate the sphygmomanometer and measure the BP (automated devices). The .gov means its official. An official website of the Department of Health & Human Services, Internet Citation: This report addresses questions regarding the clinical value of SMBP monitoring with or without additional support and what factors may predict adherence with SMBP monitoring. FOIA Self-Measured Blood Pressure Monitoring: Action Steps for Public Health Practitioners. You will receive email when new content is published. A 2012 comparative-effectiveness review by the Agency for Healthcare Research and Quality found strong evidence that SMBP plus clinical support was more effective than usual care in improving blood pressure control among patients with hypertension. and transmitted securely. In that role, she provides scientific expertise to support research translation related to Million Hearts priority strategies. Screening for High Blood Pressure in Adults: A Systematic Evidence Review for the U.S. Preventive Services Task Force [Internet]. How does SMBP monitoring compare with usual care or other interventions without SMBP in its effect on relevant clinical outcomes (cardiovascular events, mortality, patient satisfaction, quality of life, and adverse events related to antihypertensive agents)? Many have undergone validation according to the recommendations of the American Association of Medical Instrumentation, the European Society of Hypertension or the British Hypertension Society.25,29 Generally, the use of validated devices is preferred. This article presents strategies for strengthening the United States ability to address hypertension in women focusing on pregnancy-related considerations for self-measured blood pressure monitoring. Read the full Million Hearts Hypertension Control Change Package. Cite this: Self-Measured Blood Pressure Monitoring to Control Hypertension-Medscape-May06,2013. Effective Health Care Program . This table from a 2021 Current Atherosclerosis Reports journal article features oscillometric blood pressure devices validated for accuracy during pregnancy. In total, 49 studies met eligibility criteria. Kallioinen N, Hill A, Horswill MS, Ward HE, Watson MO. Comparative Effectiveness Review Number 45 Self-Measured Blood Pressure Monitoring: Comparative Effectiveness Executive Summary Background High blood pressure (BP), or hypertension, is a common, long-term health condition, particularly among older adults. The CDC 6|18 Initiative supports providing access for SMBP monitoring for home use and creating individual, provider, and health system incentives for compliance and meeting goals. 2011 Aug 8. The Forum convenes online quarterly. Several national and international hypertension guidelines endorse self-measured BP monitoring. Centers for Disease Control and Prevention. https://www.ahrq.gov/evidencenow/heart-health/blood-pressure/smbp-effectiveness.html. Self-Measured Blood Pressure Monitoring: Key Findings from a National Health Information Technology Landscape Analysis[PDF 1.3 MB] Agency for Healthcare Research and Quality (US), Rockville (MD). A 2012 comparative-effectiveness review by the Agency for Healthcare Research and Quality found strong evidence that SMBP plus clinical support was . No trials compared different SMBP devices or provided evidence on the relationship between BP control and clinical or surrogate outcomes. SMBP monitoring is the regular measurement of blood pressure by the patient outside the clinical setting, either at home or elsewhere. In total, 49 studies met eligibility criteria. Piper MA, Evans CV, Burda BU, Margolis KL, OConnor E, Smith N, Webber E, Perdue LA, Bigler KD, Whitlock EP. Hello. People using assistive technology may not be able to fully access information in these files. 7 HBPM is also known as self-measured BP. We standardized extraction by training on multiple articles, after which each study was extracted by one methodologist and the extraction reviewed by at least one other. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. To determine predictors of adherence with SMBP monitoring. SMBP = self-measured BP; KQ = Key Question. This site needs JavaScript to work properly. One study estimated that the global prevalence of hypertension in 2000 was 26 percent in the adult population. In addition, SMBP may carry the risk of unreliable BP readings if not obtained in a standard fashion, inappropriate self adjustments of antihypertensive medications, as well as increased anxiety in susceptible patients. Target: BP: Implement SMBP We take your privacy seriously. Resources for Public Health Professionals, Improving Medication Adherence Among Patients with Hypertension, Hypertension Control Challenge Rules and Eligibility, Hypertension Control Champions Success Stories, Hospitals & Health Systems Recognition Program, Spotlight: NYC Health + Hospitals/Metropolitan, Spotlight: The Ohio State University and Wexner Medical Center, Spotlight: New Hanover Regional Medical Center, COVID-19 and Cardiovascular Disease Partner Toolkit, Heart-Healthy Steps Campaign Partner Toolkit, "Live to the Beat" Campaign Partner Toolkit, Self-Measured Blood Pressure (SMBP) Monitoring Implementation Toolkit [PDF - 2 MB], U.S. Please enable it to take advantage of the complete set of features! Details on design, patients, interventions, outcomes, and quality were extracted into standard forms. SMBP requires the use of a home blood pressure measurement device by the patient to measure blood pressure at different points in time. Current insurance coverage for SMBP plus clinical support is limited and improvements are planned or are under way. These cookies may also be used for advertising purposes by these third parties. You can review and change the way we collect information below. To sign up for updates or to access your subscriberpreferences, please enter your contact information below. Balk has over 125 publications on systematic reviews of a broad range of medical, surgical, health, and nutrition topics. Sit correctly. The present Comparative Effectiveness Review (CER) evaluates the effects of self-measured blood pressure (SMBP) monitoring in hypertensive patients. Conclusions: Self-Measured Blood Pressure Monitoring: Comparative Effectiveness. They help us to know which pages are the most and least popular and see how visitors move around the site. European Associations Review Dietary Therapies for Obesity, AHA Statement Ranks 10 Popular Diets for Heart Health. %%EOF Findings may be used for research purposes, but should not be considered current. Oscillometric Blood Pressure Devices Validated for Accuracy During Pregnancy [PDF 441 KB] Taking Control of My Blood Pressure: DAngelos Story BP as recorded in the office or clinic setting at medical encounters is the most commonly used approach for measurement of BP. Comparative Effectiveness Review No. This report can help policymakers learn more about which payers have programs that cover and reimburse for SMBP monitoring. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness. No studies of SMBP monitoring in children were identified. Whether or not to advise the use of an SMBP monitoring device for a patient with hypertension is a common clinical question for clinicians. [3] (Figure 2). An official website of the Department of Health & Human Services. Patient-provider feedback loop.Source:Centers for Disease Control and Prevention. This video from the NACHC features Natalia, a patient who explains how she has taken control of her blood pressure with SMBP monitoring. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. These blood pressure monitors are easy and safe to use. SMBP with or without additional support may confer a small benefit in BP control compared with usual care, but the BP effect beyond 12 months and the attendant long-term clinical consequences remain unclear. There is insufficient evidence concerning predictors of SMBP adherence. 5600 Fishers Lane He has led the Evidence Review Teams for numerous guidelines for management of kidney disease, gynecological surgery, orthopedic surgery, and triaging in resource-poor countries. Cookies used to make website functionality more relevant to you. An official website of the United States government. (Prepared by the Tufts Evidence . . Would you like email updates of new search results? To review the role of self-measured blood pressure (SMBP) monitoring with or without additional support (interventions such as telemonitoring, counseling, education, Web support, behavioral interventions, home visits, etc.) Study Selection: Future research should standardize patient inclusion criteria, BP treatment targets for home BP, and SMBP and additional support protocols to maximize the interpretability and applicability of SMBP trials. No studies evaluated children. Lin JS, O'Connor E, Rossom RC, Perdue LA, Burda BU, Thompson M, Eckstrom E. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013 Nov. Report No. Updated Hypertension Guidelines: Implications for Treatment? Self-Measured Blood Pressure Monitoring: Comparative Effectiveness. No matter your age, you also can take steps each day to help keep your blood pressure in a healthy range. 8. How do health care professionals measure my blood pressure? OF SELF-MEASURED BLOOD PRESSURE MONITORING INTERVENTIONS CENTERS FOR DISEASE CONTROL AND PREVENTION . Uhlig K, Balk EM, Patel K, Ip S, Kitsios GD, Obadan NO, et al. This program from the AMA and Johns Hopkins University School of Medicine is designed to help physician offices and health centers engage patients in SMBP monitoring. 45. MeSH The bold lines indicate the comparisons addressed in the Key Questions (see below). 2012 Feb 15. In otherwise healthy adults, hypertension is defined as a persistently elevated BP equal to or greater than 140/90 mmHg.1 The recommended BP measurement technique is to average two readings taken in a person after 5 minutes quietly seated in chair.1 In children, the diagnosis is made from an average of three or more BP readings greater than the 95th percentile for age, sex, and height.2,3 The Seventh Joint National Committee (JNC 7) guideline recommends a BP goal of 140/90 mmHg or less in the general population and a lower goal of 130/80 mmHg or less in patients with diabetes mellitus or chronic kidney disease.1. The choice of treatment is largely dependent on the cause of hypertension, severity of the condition, as well as the presence or absence of existing comorbid states. Current settings for BP measurement include BP measurement in a healthcare setting, or BP measurement in a patient's usual environment with either ambulatory BP monitoring, or self-measured BP (SMBP) monitoring. Introduction. Many things can affect a blood pressure reading, including: Its important to get an accurate blood pressure reading so that you have a clearer picture of your risk for heart disease and stroke. SMBP monitoring may be used as a tool for disease self-management and to improve adherence with lifestyle and diet modification, or with drug treatment. For additional assistance, please contact us. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. AHRQ Projects funded by the Patient-Centered Outcomes Research Trust Fund. Internet Citation: Data Synthesis: Unauthorized use of these marks is strictly prohibited. Recommended management strategies for BP control include lifestyle and behavior modification (such as smoking cessation, moderation of alcohol consumption, salt restriction and other dietary modifications, regular exercise, and weight loss in obese persons), usually combined with the use of antihypertensive medication. Rockville (MD): Agency for Healthcare Research and Quality (US); 2007. Today, as part of the CDC Expert Commentary Series on Medscape, I would like to talk about self-measured blood pressure (SMBP) monitoring plus clinical support as a way to help patients manage their hypertension. i` V04s7.w`t32Cc( L4M\ES}*vWe+= 4a)\5O)si8hQ[^}.L01>#t7On,c7g K>=}NrMo4;Zj:97MgN1m#6+U6i How can I measure my blood pressure at home? The direct and indirect cost of high BP and its complications has been estimated at more than $43.5 billion in 2007 in the U.S.7 Thus, it cannot be viewed simply as an individual health issue given the large public health impact and the potential for cost savings with effective prevention or treatment. Self-measured blood pressure (SMBP) monitoring, the regular measurement of blood pressure (BP) by the patient at home, has been proposed as a means of improving treatment adherence and BP control. Comparative Effectiveness Review No. The Community Preventive Services Task Force (CPSTF) Recommendations on Self-Measured Blood Pressure Monitoring Interventions Obtaining Adequate Fixation in a Periprosthetic Humerus Fracture Around a Shoulder Arthroplasty Stem in 81-Year-Old Man, ECG Challenge: Irregular Pulse During Cardiology Visit.
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