Guidelines for Home Blood Pressure Monitoring

Abstract

Self-measurement of blood pressure at home by patients with hypertension is being widely used for several decades in many countries. Statements and guidelines for using home blood pressure monitoring for hypertension management have been published in the last three decades in the USA, Canada, Europe, Australia, and Japan. Initially there was some caution by several organizations in using home blood pressure measurements for decision-making in hypertension. However, in the last two decades the publication of outcome studies showing superiority of home measurements in predicting risk compared to the conventional office measurements has supported a major role for home blood pressure monitoring in decision-making in hypertension. Several organizations recommend ambulatory blood pressure monitoring as the primary method for hypertension diagnosis, with home monitoring proposed as a useful alterative. However, home blood pressure monitoring is much more widely available than ambulatory monitoring, it is preferred by most patients, and has been shown to improve patients’ long-term compliance with treatment and thereby hypertension control rates. Thus, home blood pressure monitoring is currently recommended for wide clinical application in subjects with suspected or treated hypertension, as it offers a pragmatic approach for out-of-office blood pressure evaluation for clinical practice. Efforts to implement the wide use of home blood pressure monitoring would likely enhance the diagnosis and control of hypertension across communities.