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Self-blood-pressure monitoring—a questionnaire study: response, requirement, training, support-group popularity and recommendations

Journal of Human Hypertension volume 17, pages 51–61 (2003)Cite this article

Abstract

The objective of this study was to survey hypertensive patients' response to, requirement for and training in self-blood pressure monitoring (SBPM). A total of 222 hypertensives were invited to complete a questionnaire even when not participating in the project. Questions supplied information on demographics, monitoring frequency, convenience of attending the surgery, monitor ownership and preference for and ease of self-monitoring. Comments supplied qualitative data. Training group questionnaires supplied similar data as well as SBPM data before and after training. Of 133 respondents, a higher educated, younger, wider age range wanted to participate (76; 57.2%) and tended to self-monitor. However, only an increase in further education (FE) was associated with an increased probability of participation and inclination to self-monitor in the multivariate analyses. A positive relationship exists between age and frequency in both groups. About a sixth of respondents own monitors and ownership is correlated to FE. Although most patients found it convenient to visit the surgery, the percentage finding it convenient was lower in patients attending training sessions than in the original survey, possibly indicating that independence is important for SBPM. Younger, higher-educated patients tended to self-monitor although FE was again the significant factor. Training increased preference for the idea of SBPM, prospective monitor ownership (64.8% of non-owners) and self-monitoring intention (76.1%). Patients found recording card listed cardiovascular disease (CVD) risks valuable and 69.6% (32) wanted to establish a support group. Comments and interviews indicated haphazard knowledge, routines and uncertainty about SBPM. A standardised procedure including patient assessment, SBPM protocol and lifestyle education is needed for SBPM to be successful.

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References

  1. Pieper JA . Management of coronary heart disease risk factors and progression with calcium blockers. Pharmacotherapy 2001; 21: 195S–208S.

    Article  CAS  PubMed  Google Scholar 

  2. Ruilope LM, Schiffrin EL . Blood pressure control and benefits of antihypertensive therapy: does it make a difference which agents we use? Hypertension 2001; 38: 537–542.

    Article  CAS  PubMed  Google Scholar 

  3. Department of Health. Saving lives: our healthier nation. Department of Health 1999; pp 72–73.

  4. PROGRESS Collaborative Group. Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6105 individuals with previous stroke or transient ischaemic attack. Lancet 2001; 358: 1033–1041.

  5. Mensah GA . Refining strategies for the prevention and control of hypertension and related complications. Ethn Dis 1999; 9: 327–332.

    CAS  PubMed  Google Scholar 

  6. Department of Health. Saving lives: our healthier nation Department of Health 1999; pp76–77.

  7. Department of Health. Patient and public involvement in the new NHS. Department of Health Report 1999. Also found at:http://www.doh.gov.uk/pub/docs/doh/ppinvolvement.pdf.

  8. Jula A, Puukka P, Karanko, . Multiple clinic and home blood pressure measurements versus ambulatory blood pressure monitoring. Hypertension 1999; 34: 261–266.

    Article  CAS  PubMed  Google Scholar 

  9. Comas A et al. The evaluation of the hypertensive patient via self-measured blood pressure at home. Atten Primaria 1998; 22: 142–148.

    CAS  Google Scholar 

  10. Ramsay LE et al. Guidelines for management of hypertension: report of the third working party of the British Hypertension Society. J Hum Hypertens 1999; 13: 569–592.

    Article  CAS  PubMed  Google Scholar 

  11. Torres Jimenez J et al. Variations in the prevalence and patient profile of white-coat syndrome, according to its definition using self-measurement of blood pressure at home. Atten Primaria 2001; 28: 234–240.

    Article  CAS  Google Scholar 

  12. Balas EA, Iakovidis I . Distance technologies for patient monitoring. BMJ 1999; 319: 1309

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Department of Health. National Service Frameworks Coronary Heart Disease Modern Standards and Service Models. Department of Health, 2000.

  14. Hippisley-Cox J, Pringle M . General practice workload implications of the national service framework for coronary heart disease: cross sectional study. BMJ 2001; 323: 269–270.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Stergiou GS et al. Home monitoring of blood pressure: limited value in general practice. J Hum Hypertens 1996; 10: 219–223.

    CAS  PubMed  Google Scholar 

  16. Merrick RD et al. Factors influencing the accuracy of home blood pressure measurement. South Med J 1997; 90: 1110–1114.

    Article  CAS  PubMed  Google Scholar 

  17. Johnson KA, Partsch DJ, Rippole LL, McVey DM . Reliability of self-reported blood pressure measurements. Arch Intern Med 1999; 159: 2689–2693.

    Article  CAS  PubMed  Google Scholar 

  18. Jeck T et al. Performing self-measurement of blood pressure: a patient survey. Schweiz Rundsch Med Prax 1991; 80: 456–461.

    CAS  PubMed  Google Scholar 

  19. Bailey B, Carney SL, Gillies AA, Smith AJ . Antihypertensive drug treatment: a comparison of usual care with self blood pressure measurement. J Hum Hypertens 1999; 13: 147–150.

    Article  CAS  PubMed  Google Scholar 

  20. Nordmann A et al. Reliability of patients measuring blood pressure at home: prospective observational study. BMJ 1999; 319: 1172

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Birkett NJ et al. Self-measurement of blood pressure: issues related to the training of patients. Canadian Coalition for High Blood Pressure Prevention and Control. Can J Cardiol 1995; 11: 23H–27H.

    PubMed  Google Scholar 

  22. Tyson M . Blood pressure self-monitoring evaluation. July 2001, 69pp

  23. Moser C, Kalton G . Survey Methods in Social Investigation, 2nd edn. Dartmouth Publishing Company Limited, Hants, UK, 1979.

    Google Scholar 

  24. Lee J, Chia KS . Estimation of prevalence rate ratios for cross sectional data: an example in occupational epidemiology. Br J Ind Med 1993; 50: 861–864.

    CAS  PubMed  PubMed Central  Google Scholar 

  25. Jo I et al. Prevalence, awareness, treatment, control and risk factors of hypertension in Korea: the Ansan study. J Hypertens 2001; 19: 1523–1532.

    Article  CAS  PubMed  Google Scholar 

  26. Ibrahim MM et al. Hypertension prevalence, awareness, treatment and control in Egypt. Results from the Egyptian National Hypertension Project (NHP). NMP Investigative Team. Hypertension 1995; 26: 886–890.

    Article  CAS  PubMed  Google Scholar 

  27. Sonmez HM et al. The epidemiology of elevated blood pressure as an estimate for hypertension in Aydin, Turkey. J Hum Hypertens 1999; 13: 399–404.

    Article  CAS  PubMed  Google Scholar 

  28. Franklin SS et al. Does the relation of blood pressure to coronary heart disease risk change with aging?. Circulation 2001; 103: 1245.

    Article  CAS  PubMed  Google Scholar 

  29. O'Brien E et al. Blood pressure measuring devices: recommendations of the European Society of Hypertension. BMJ 2001; 322: 531–536.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Hanon O et al. Blood pressure self-monitoring contributes to improved patient education among hypertensive subjects. Arch Mal Coeur Vaiss 2001; 94: 879–883.

    CAS  PubMed  Google Scholar 

  31. Le Pailleur C et al. Talking effect and ‘white coat’ effect in hypertensive patients: physical effort or emotional content?. Behav Med 2001; 26: 149–157.

    Article  CAS  PubMed  Google Scholar 

  32. Myers MG, Meglis G, Polemidiotis G . The impact of physician vs automated blood pressure readings on office-induced hypertension. J Hum Hypertens 1997; 11: 491–493.

    Article  CAS  PubMed  Google Scholar 

  33. Aivazyan TA et al. Psychophysiological interrelations and reactivity characteristics in hypertensives. Health Psychol 1988; 7(Suppl): 139–144.

    Article  PubMed  Google Scholar 

  34. Un S, Mengden T, Vetter H . Your patient self-monitors his blood pressure. Other limit values are applicable. MMW Fortschr Med 2000; 142: 28–30.

    CAS  PubMed  Google Scholar 

  35. Mengden T et al. User procedure for self-measurement of blood pressure. First International Consensus Conference on Self Blood Pressure Measurement. Blood Press Monit 2000; 5: 111–129.

    CAS  PubMed  Google Scholar 

  36. Medical Devices Agency. Blood Pressure Measurement Devices—Mercury and Non-mercury, Device bulletin MDA DG2000 (03: Department of Health 2000)

  37. Kannel WB et al. The Framingham Study: ITS 50-year legacy and future promise. J Atheroscler Thromb 2000; 6: 60–66.

    Article  CAS  PubMed  Google Scholar 

  38. Paganini-Hill A, Perez Barreto M . Stroke risk in older men and women: aspirin, estrogen, exercise, vitamins, and other factors. J Gend Specif Med 2001; 4: 18–28.

    CAS  PubMed  Google Scholar 

  39. Butler RN et al. Hypertension: setting new goals for lower readings. Geriatrics 1999; 54: 20–21, 25–26, 29–30.

    CAS  PubMed  Google Scholar 

  40. Kjellgren KI, Svensson S, Ahlner J, Saljo R . Hypertensive patients' knowledge of high blood pressure. Scand J Prim Health Care 1997; 15: 188–192.

    Article  CAS  PubMed  Google Scholar 

  41. Trilling JS, Froom J . The urgent need to improve hypertension care. Arch Fam Med 2000; 9: 794–801.

    Article  CAS  PubMed  Google Scholar 

  42. Bortolotto LA et al. Feasibility and importance of self-monitoring in patients over 75 years old. Arch Mal Coeur Vaiss 1999; 92: 1159–1162.

    CAS  PubMed  Google Scholar 

  43. Ashida T et al. Profiles of patients who control the doses of their antihypertensive drugs by self-monitoring of home blood pressure. Hypertens Res 2001; 24: 203–207.

    Article  CAS  PubMed  Google Scholar 

  44. White WB et al. Task force VI: self-monitoring of the blood pressure. Blood Press Monit 1999; 4: 343–351.

    CAS  PubMed  Google Scholar 

  45. Veglio F et al. Ambulatory blood pressure monitoring and clinical characteristics of the true and white-coat resistant hypertension. Clin Exp Hypertens 2001; 23: 203–211.

    Article  CAS  PubMed  Google Scholar 

  46. Addison C, Varney S, Coats A . The use of ambulatory blood pressure monitoring in managing hypertension according to different treatment guidelines. J Hum Hypertens 2001; 15: 535–538.

    Article  CAS  PubMed  Google Scholar 

  47. Jeck T et al. Self measurement of blood pressure: patient education. Schweiz Rundsch Med Prax 1989; 78: 1346–1349.

    CAS  PubMed  Google Scholar 

  48. Brook RD . Home blood pressure: accuracy is independent of monitoring schedules. Am J Hypertens 2000; 13: 625–631.

    Article  CAS  PubMed  Google Scholar 

  49. Stanton JA, Lowenthatl DT . The evidence for lifestyle modification in lowering blood pressure in the elderly. Am J Geriatr Cardiol 2000; 9: 27–33.

    Article  PubMed  Google Scholar 

  50. Maitland-van der Zee et al. The association between antihypertensive drug therapies and plasma lipid levels in the general population. J Hum Hypertens 2001; 15: 701–705.

    Article  Google Scholar 

  51. Tomaszewski M et al. Some aspects of non-pharmacologic treatment of hypertension. Przegl Lek 1999; 56: 579–583.

    CAS  PubMed  Google Scholar 

  52. Boulware LE et al. An evidence-based review of patient-centered behavioral interventions for hypertension(1). Am J Prev Med 2001; 21: 221–232.

    Article  CAS  PubMed  Google Scholar 

  53. Jacob RG et al. Relaxation therapy for hypertension: setting-specific effects. Psychosom Med 1992; 54: 87–101.

    Article  CAS  PubMed  Google Scholar 

  54. Ashida T et al. Relationship between home blood pressure measurement and medication compliance and name recognition of antihypertensive drugs. Hypertens Res 2000; 23: 21–24.

    Article  CAS  PubMed  Google Scholar 

  55. Reid CM, Maher T, Jennings GL . Heart Project Steering Committee. Substituting lifestyle management for pharmacological control of blood pressure: a pilot study in Australian general practice. Blood Press 2000; 9: 267–274.

    Article  CAS  PubMed  Google Scholar 

  56. Reilly JJ, Dorosty AR . Epidemic of obesity in UK children. Lancet 1999; 354: 1874–1875.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

We are grateful to Mr Colin Penney for being the project demonstrator, the staff at Hadfield Medical Centre, 82 Brosscroft, Hadfield, Glossop, Derbyshire, UK, for their help and the project location, HMC patients for their time and patience and Glossopdale Primary Care Sub-Group and West Pennine Health Authority for funding the project.

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  1. Patient Involvement Task Force, Glossopdale Primary Care Sub-Group, Hadfield Clinic, Hadfield, Glossop, Derbyshire, UK

    M J Tyson

  2. The Medical School, The University of Manchester, Manchester, UK

    P McElduff

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Correspondence to M J Tyson.

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Tyson, M., McElduff, P. Self-blood-pressure monitoring—a questionnaire study: response, requirement, training, support-group popularity and recommendations. J Hum Hypertens 17, 51–61 (2003). https://doi.org/10.1038/sj.jhh.1001510

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