Home Blood Pressure Monitoring
Home Blood Pressure Monitoring
Home blood pressure monitoring (HBPM) is a self-management tool that advanced practice nurses can incorporate into care for patients with hypertension. Evidence supports the benefits of patient HBPM compared to office-based monitoring by providers alone. HBPM is a method for patients to partner with providers with their self-care management. The goals of incorporating HBPM into practice include improving quality and outcomes and controlling costs. HBPM interventions include team-based care, patient education and self-management skills, and evidence-based guidelines, concepts that are consistent with Wagner's Chronic Care Model. HBPM should be considered as policy guideline for hypertensive patients.
Hypertension is a chronic disease that poses a risk for cardiovascular disease and increases the risk of heart attack, stroke, kidney disease, and heart failure. Data from 2007–2010 indicate that 33% of adults 20 and older—an estimated 78 million—in the United States have hypertension. Prevalence is nearly equal among men and women. African American adults have among the highest rates of hypertension in the world, at 44%. In US populations with hypertension, 82% are aware of their condition and only 53% are diagnosed and control their blood pressure (BP) at target levels. Financial costs directly related to hypertension in the US total almost $131 billion annually in direct medical expenses and $25 billion in lost productivity.
In the past, BP measurement was traditionally performed in the primary care provider's office. Digital devices for home blood pressure monitoring (HBPM) are now available over the counter for self-care. A scientific statement from the American Heart Association, American Society of Hypertension, and Preventive Cardiovascular Nurses Association states that home BP readings are more reproducible than office readings and show better correlations with measures of target organ damage. They recommend HBPM become a routine component of BP measurement in the majority of patients with known or suspected hypertension, and that patients should be shown how to use the devices by their health care providers.
HBPM overcomes many limitations of traditional office BP measuring and is cheaper and easier to perform than ambulatory (24-hour) monitoring. New monitors that use oscillometric methods to show accurate readings according to standard international protocols are reliable, easy to use, and relatively inexpensive. The European Society of Hypertension Practice Guidelines for HBPM summarizes available evidence, provides recommendations on its use in clinical practice and research, and supports it as a valuable tool in the daily management of hypertension. Self-monitoring should always be in collaboration with medical supervision, where providers consider a patient's overall clinical conditions and cardiovascular and renal profile.
Abstract and Introduction
Abstract
Home blood pressure monitoring (HBPM) is a self-management tool that advanced practice nurses can incorporate into care for patients with hypertension. Evidence supports the benefits of patient HBPM compared to office-based monitoring by providers alone. HBPM is a method for patients to partner with providers with their self-care management. The goals of incorporating HBPM into practice include improving quality and outcomes and controlling costs. HBPM interventions include team-based care, patient education and self-management skills, and evidence-based guidelines, concepts that are consistent with Wagner's Chronic Care Model. HBPM should be considered as policy guideline for hypertensive patients.
Introduction
Hypertension is a chronic disease that poses a risk for cardiovascular disease and increases the risk of heart attack, stroke, kidney disease, and heart failure. Data from 2007–2010 indicate that 33% of adults 20 and older—an estimated 78 million—in the United States have hypertension. Prevalence is nearly equal among men and women. African American adults have among the highest rates of hypertension in the world, at 44%. In US populations with hypertension, 82% are aware of their condition and only 53% are diagnosed and control their blood pressure (BP) at target levels. Financial costs directly related to hypertension in the US total almost $131 billion annually in direct medical expenses and $25 billion in lost productivity.
In the past, BP measurement was traditionally performed in the primary care provider's office. Digital devices for home blood pressure monitoring (HBPM) are now available over the counter for self-care. A scientific statement from the American Heart Association, American Society of Hypertension, and Preventive Cardiovascular Nurses Association states that home BP readings are more reproducible than office readings and show better correlations with measures of target organ damage. They recommend HBPM become a routine component of BP measurement in the majority of patients with known or suspected hypertension, and that patients should be shown how to use the devices by their health care providers.
HBPM overcomes many limitations of traditional office BP measuring and is cheaper and easier to perform than ambulatory (24-hour) monitoring. New monitors that use oscillometric methods to show accurate readings according to standard international protocols are reliable, easy to use, and relatively inexpensive. The European Society of Hypertension Practice Guidelines for HBPM summarizes available evidence, provides recommendations on its use in clinical practice and research, and supports it as a valuable tool in the daily management of hypertension. Self-monitoring should always be in collaboration with medical supervision, where providers consider a patient's overall clinical conditions and cardiovascular and renal profile.
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