1. ¹Department of Medicine, Turku University Hospital, Turku, Finland
2. ²Department of Pharmacy, Kuopio University, Kuopio, Finland

Correspondence: Dr. Ilkka Kantola, Turku University Hospital, Department of Medicine, 20520 Turku, Finland E-mail: ilkka.kantola@tyks.fi

^*This work was supported by Pfizer Finland by provision of blood pressure measurement devices used in the study, education of the physicians and management of the program on the primary health care level.

Received 25 January 2005; Revised 3 April 2005; Accepted 9 May 2005.

Abstract

Background: The majority of hypertensive patients do not reach the target blood pressure (BP). We sought to clarify whether intermittent self-monitoring of BP leads to better BP control compared to ordinary treatment in general practice.

Methods: Two hundred sixty-nine hypertensive patients participated in this multicenter, randomized, parallel-group study in primary health care. Home BP was measured in the self-monitoring (SM) group at 0, 2, 4, and 6 months, and in the control (C) group at 0 and 6 months. The participating physicians were instructed to intensify the antihypertensive therapy when needed.

Results: At the beginning, both groups had similar home BP levels (SM 143.1 17.4/85.3 7.4 mm Hg v C 143.9 18.3/85.4 7.5 mm Hg). After 6 months, there were significant decreases in systolic (P .0001), diastolic (P .0029), and pulse pressures (P .021) in both groups. Systolic (-7.8 13.1 mm Hg v -4.5 12.2 mm Hg, P = .047) and pulse pressure (-4.7 9.0 mm Hg v -2.2 10.0 mm Hg, P = .042) decreased significantly more than in the self-monitoring group. The decrease in diastolic pressure was similar in both groups (SM -3.1 6.2 mm Hg v C -2.3 8.3 mm Hg, P = not significant). The patients in the SM group reached home BP target more often than those in the C group (29% v 16%, P = .016). There was a nonsignificant trend toward lower office BP values in the SM group.

Conclusions: Self-monitoring decreased systolic and pulse pressure significantly more than ordinary treatment and promoted achievement of target BP. This was most likely due to improved patient compliance and more active treatment by the physicians. Our results suggest that home measurement is useful in the control of hypertension.