343 0 obj <>stream To accelerate SMBP use, the Centers for Disease Control and Prevention (CDC) funded the National . 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. Thus an alternative term for SMBP monitoring which better captures the application of self measurement for this report is the term home BP monitoring; however since the term is relatively rarely used in the literature, we will continue to use SMBP. 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. Measuring your blood pressure is the only way to know whether you have high blood pressure. People using assistive technology may not be able to fully access information in these files. There is no consensus on the precise protocol for SMBP monitoring in the management of hypertension regarding timing, frequency and duration. Hypertension often requires lifelong treatment. include self-measured blood pressure monitoring (SMBP) plus additional clinical support and empowerment of non-physician clinicians (e.g. Project Timeline. Take your blood pressure at the same time every day. Careers. PMC Share this graphic with family and friends to show them the correct way to measure blood pressure. The full report, listing all studies, is available at www.effectivehealthcare.ahrq.gov/selfmeasuredbp.cfm. Take at least two readings, 1 or 2 minutes apart. Self-blood pressure monitoring, by itself, has been shown to be an effective tool in predominantly white populations, but less studied in minority, urban communities. 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.) As self-measurement requires patient participation, certain patient characteristics may affect compliance with SMBP monitoring, such as the willingness and ability to self-monitor BP and the technical literacy in operating the device or an interface for telemonitoring. In: Comparative Effectiveness Review Summary Guides for Clinicians [Internet]. 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. The health care professional will slowly let air out of the cuff while listening to your pulse with a stethoscope and watching the gauge. Document author(s)/institution of origin: Effective Health Care Program, Agency for Healthcare Research and . 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. To sign up for updates or to access your subscriberpreferences, please enter your contact information below. Effective Health Care Program, Agency for Healthcare Research and Quality, Rockville, MD. The population of interest is the general population of people with hypertension, excluding pregnant women or those receiving dialysis. You will receive email when new content is published. Use this printable and shareable list of questions to ask your health care team to help you manage your blood pressure. For appropriate diagnosis and therapy, accurate BP measurement is of great importance. Unauthorized use of these marks is strictly prohibited. Piper MA, Evans CV, Burda BU, Margolis KL, OConnor E, Smith N, Webber E, Perdue LA, Bigler KD, Whitlock EP. No trials compared different SMBP devices or provided evidence on the relationship between BP control and clinical or surrogate outcomes. High blood pressure usually has no warning signs or symptoms, and many people do not know they have it. 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. Finally, SMBP may be useful in preventing overtreatment in individuals with white coat syndrome, orthostatic BP changes, or hypotensive episodes from medication. 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. It has been the subject of a 2002 Evidence Practice Center (EPC) Evidence Report.25 A fuller description of ambulatory BP monitoring can be found there. Randomized-controlled trials have shown that self-measured blood pressure predicts cardiovascular morbidity and mortality better than office BP measurements. No studies of SMBP monitoring in children were identified. Brown Affiliations Rockville, MD: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services; 2012. Effective BP control has been shown to decrease incidence for stroke by 35 to 40 percent, myocardial infarction by 20 to 25 percent, and heart failure more than 50 percent.11,12 Systematic reviews have also shown the beneficial effects of lowering BP on reducing fatal and nonfatal stroke, cardiac events, and total among individuals with severe hypertension or at increased risk (such as of older age or with other comorbid risk factors).11,13,14 A decrease of 5 mmHg in systolic BP has been estimated to result in a 14 percent overall reduction in mortality due to stroke, 9 percent reduction in mortality due to chronic heart disease and 7 percent reduction in all-cause mortality.1,15,16 However, long-term adherence to lifestyle modification and medication remains a challenge in the management of hypertension, which is usually a lifelong condition. This feature requires the newest version of Flash. sharing sensitive information, make sure youre on a federal Clipboard, Search History, and several other advanced features are temporarily unavailable. Systematic Review: For SMBP alone versus usual care, the strength of evidence is moderate and supports a lower BP with SMBP (SBP/DBP -3.1/-2.0 mmHg at 6 months). Using SMBP to guide you in diagnosing and treating hypertension likely will produce better outcomes than using office blood pressure readings alone. BP as recorded in the office or clinic setting at medical encounters is the most commonly used approach for measurement of 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. Patients in the intervention group and their providers, received feedback on self-monitored blood pressure results and optional lifestyle advice and motivational support. SMBP Coverage Insights: Medicaid [PDF 232 KB] In total, 49 studies met eligibility criteria. How Do We Jump-Start Self-measured Blood Pressure Monitoring in the United States? Given the inconvenience and expense of setting up and using the device, ambulatory BP monitoring is predominantly used to diagnose white coat or masked hypertension, to identify people with abnormal daily BP patters, or to help with management of hard to control or highly variable BP. Learn the correct way to have your blood pressure taken, whether youre getting it checked at the doctors office or checking it yourself at home. We also included longitudinal cohort studies in addressing adherence predictors. This 2020 AMA handout for Current Procedural Terminology (CPT) provides codes and descriptions for SMBP-related services. National Library of Medicine 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). Please enable it to take advantage of the complete set of features! How can I measure my blood pressure at home? J Athl Train. An official website of the United States government. Please enter a Recipient Address and/or check the Send me a copy checkbox. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2013. Rockville (MD): Agency for Healthcare Research and Quality (US); 2007. There is growing evidence that selfmonitoring of blood pressure (SMBP) with guided support beyond usual primary care improves BP control. Self-measured BP (SMBP) monitoring is another option that allows for more frequent measurements, and possibly more accurate readings of a patient's typical BP. 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. 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. You will be subject to the destination website's privacy policy when you follow the link. January 2012 As they were scoping their work for SMBP, they started by searching multiple databases Measure your blood pressure regularly to help your health care team diagnose any health problems early. 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. Data Sources: Patients are instructed to keep an activity log throughout the testing period for evaluation of stress- and activity-related BP changes. Strong scientific evidence shows that self-measured blood pressure (SMBP) monitoring, also known as home blood pressure monitoring, plus clinical support helps people with hypertension lower their blood pressure. >gL/?eEAV c,1t D~ 8-?x}0 KQUo~TJa&A6@sY(|x D G&pA32^Y|VLEcx 71HbFFhi3"9#+Z~GqESHm,Y-G1.
How Much Do Football Mascots Get Paid Uk,
How Long Do Fingerprints Last At A Crime Scene,
Articles S