J Korean Soc Hypertens.  2012 Jun;18(2):63-70. 10.5646/jksh.2012.18.2.63.

Usefulness of Home Blood Pressure Reflected Anti-hypertensive Treatment and the Evolution of Blood Pressure Profiles

• Lee JH
• Kim SM
• Lee SY
• Bae JW
• Hwang KK
• Kim DW
• Cho MC

• KMID: 1436342
• DOI: http://doi.org/10.5646/jksh.2012.18.2.63

Abstract

BACKGROUND
It is still unclear how self-measured home blood pressure (BP) evolves over time in treated hypertensive patients, and the usefulness of home BP based treatment is under debate.
METHODS
The patients whose anti-hypertensive medications had not been changed at least 6 months were enrolled. They measured home BP at enrollment and at study end. The patients were classified into controlled hypertension (CH), hypertension with white coat effect (WCH), hypertension with reverse white coat effect (RWCH), and uncontrolled hypertension (UH), based on their clinic and home BP. Their home BP profiles were reflected in the patients' treatments, instead of relying solely on clinic BP.
RESULTS
Ninety patients (mean age, 56.5 +/- 9.9; male, 57.8%) were analyzed and mean follow-up duration was 34.1 +/- 3.6 months. CH, WCH, RWCH, and UH patients were 33.3% (30 patients), 37.8% (34 patients), 5.6% (5 patients), and 23.3% (21 patients), respectively at enrollment. Almost all CH and WCH patients remained in normal range of home BP whereas about half of RWCH and UH patients moved to CH or WCH. As a result, the proportion of RWCH and UH decreased at the end of follow-up. Overall clinic and home BP reduced significantly in all groups. Clinic BP declined significantly in WCH and UH, whereas home BP declined significantly in RWCH and UH. That means the BP profiles shifted toward more reasonable states.
CONCLUSIONS
BP profiles shifted toward more reasonable states after home BP based adjustment of anti-hypertensive medication. Measurement of home BP might be beneficial in anti-hypertensive treatment.

Keyword

Hypertension; Home blood pressure monitoring; White coat effect

MeSH Terms

Blood Pressure
Blood Pressure Monitoring, Ambulatory
European Continental Ancestry Group
Follow-Up Studies
Humans
Hypertension
Male
Reference Values

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