Identifier to cite or link to this item: http://hdl.handle.net/20.500.13003/15491
Self-monitoring of Blood Pressure in Patients With Hypertension-Related Multi-morbidity: Systematic Review and Individual Patient Data Meta-analysis
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AuthorSheppard, J. P.; Tucker, K. L.; Davison, W. J.; Stevens, R.; Aekplakorn, W.; Bosworth, H. B.; Bove, A.; Earle, K.; Godwin, M.; Green, B. B.; Hebert, P.; Heneghan, C.; Hill, N.; Hobbs, F. D. R.; Kantola, I.; Kerry, S. M.; Leiva, A.; Magid, D. J.; Mant, J.; Margolis, K. L.; McKinstry, B.; McLaughlin, M. A.; McNamara, K.; Omboni, S.; Ogedegbe, O.; Parati, G.; Varis, J.; Verberk, W. J.; Wakefield, B. J.; McManus, R. J.
Document typereview article
CitationSheppard JP, Tucker KL, Davison WJ, Stevens R, Aekplakorn W, Bosworth HB, et al. Self-monitoring of Blood Pressure in Patients With Hypertension-Related Multi-morbidity: Systematic Review and Individual Patient Data Meta-analysis. Am J Hypertens. 2020 Mar;33(3):243-51.
BACKGROUND Studies have shown that self-monitoring of blood pressure (BP) is effective when combined with co-interventions, but its efficacy varies in the presence of some co-morbidities. This study examined whether self- monitoring can reduce clinic BP in patients with hyper tension-related co-morbidity. METHODS A systematic review was conducted of articles published in Medline, Embase, and the Cochrane Library up to January 2018. Randomized controlled trials of self-monitoring of BP were selected and individual patient data (IPD) were requested. Contributing studies were prospectively categorized by whether they examined a low/ high-intensity co-intervention. Change in BP and likelihood of uncontrolled BP at 12 months were examined according to number and type of hypertension-related co-morbidity in a one-stage IPD meta-analysis. RESULTS A total of 22 trials were eligible, 16 of which were able to provide IPD for the primary outcome, including 6,522 (89%) participants with fol low-up data. Self-monitoring was associated with reduced clinic systollc BP compared to usual care at 12-month follow-up, regardless of the number of hypertension-related co-morbidities (-3.12 mm Hg, [95% confidence intervals -4.78, -1.46 mm Hg]; P value for interaction with number of morbidities = 0.260). Intense interventions were more effective than low-intensity interventions in patients with obesity (P < 0,001 for ail outcomes), and possibly stroke (P < 0,004 for BP control outcome only), but this effect was not observed in patients with coronary heart disease, diabetes, or chronic kidney disease. CONCLUSIONS Self-monitoring lower BP regardless of the number of hypertensic related co-morbidities, but may only be effective in conditions such obesity or stroke when combined with high-intensity co-interventions.
coronary heart disease
randomized controlled trial
MeSHBlood Pressure Monitoring, Ambulatory
Aged, 80 and over
Randomized Controlled Trials as Topic
Predictive Value of Tests
Factores de Tiempo
Factores de Riesgo
Persona de Mediana Edad
Valor Predictivo de las Pruebas
Anciano de 80 o más Años
Ensayos Clínicos Controlados Aleatorios como Asunto
Monitoreo Ambulatorio de la Presión Arterial