STATE-OF-THE-ART PAPER
Home Blood Pressure Measurement
A Systematic Review
Willem J. Verberk, MSc*,
Abraham A. Kroon, MD, PhD*,
Alfons G.H. Kessels, MD, MSc and
Peter W. de Leeuw, MD, PhD*,*
* Department of Medicine, University Hospital Maastricht and Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands
Department of Clinical Epidemiology and Technology Assessment, University Hospital Maastricht, Maastricht, the Netherlands
Manuscript received March 21, 2005;
revised manuscript received May 2, 2005,
accepted May 16, 2005.
* Reprint requests and correspondence: Prof. Dr. Peter W. de Leeuw, Department of Medicine, University Hospital Maastricht, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands (Email: p.deleeuw{at}intmed.unimaas.nl).
The purpose of this research was to review the literature on home blood pressure measurement (HBPM) and to provide recommendations regarding HBPM assessment. Observational studies on HBPM, published after 1992, as identified by PubMed, EMBASE, and Cochrane literature searches were reviewed. Studies were selected if they met the following criteria: 1) self-measurements had been performed with validated devices; 2) measurement procedures were described in sufficient detail; and 3) papers clearly explained how final HBPM results were calculated upon which conclusions and/or treatment decisions were based. Office blood pressure measurement (OBPM) yields higher blood pressure values than HBPM. For systolic blood pressure, differences between OBPM and HBPM increase with age and the height of office pressure. Differences also tend to be greater in men than in women and greater in patients without than in those with antihypertensive treatment. Furthermore, HBPM can diagnose normotension with almost absolute certainty; it correlates better with target organ damage and cardiovascular mortality than OBPM, it enables prediction of sustained hypertension in patients with borderline hypertension, and it proves to be an appropriate tool for assessing drug efficacy. Despite some limitations and although more data are needed, HBPM is suitable for routine clinical practice.
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Abbreviations and Acronyms
| | AAMI = Association for the Advancement of Medical Instrumentation | | ABPM = ambulatory blood pressure measurement | | BHS = British Hypertension Society | | BP = blood pressure | | CI = confidence interval | | DBP = diastolic blood pressure | | ESH = European Society of Hypertension | | HBP(M) = home blood pressure (measurement) | | OBPM = office blood pressure measurement | | SBP = systolic blood pressure | | TOD = target organ damage |
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