%0 Journal Article
%T Self-monitoring of blood pressure to guide titration of antihypertensive medication¡ªa new era in hypertension management?
%A Jan K. Ho
%A Markus P. Schlaich
%A Revathy Carnagarin
%A Vance B. Matthews
%J Archive of "Cardiovascular Diagnosis and Therapy".
%D 2019
%R 10.21037/cdt.2018.08.01
%X Hypertension remains the leading modifiable risk factor for cardiovascular morbidity and mortality worldwide and accounts for more than 10 million deaths annually (1). Despite the availability of effective pharmacotherapy, control rates of hypertension remain less than 50% in most countries. International data suggest that only half of affected subjects are aware of their elevated blood pressure (BP) and less than a third of patients receiving antihypertension treatment actually reach target BP levels (2). Indeed, the recently published data from May Measurement Month 2017, a global BP screening and awareness campaign initiated by the International Society of Hypertension, collected BP data obtained from more than 1.2 million subjects across 80 countries in a standardized fashion and revealed a global prevalence of hypertension (elevated BP >140/90 mmHg or on antihypertensive therapy) in 34.9% of the adult population (3). Moreover, 46.3% of patients who were treated for their hypertension had BP levels above 140/90 mmHg and hence remained uncontrolled, thereby leaving these patients at increased CV risk (3). Suboptimal prescribing practices, the lack of awareness and difficulty obtaining reliable BP measurements are some of the factors contributing to suboptimal BP control. Increased use of out-of-office BP measurements, particularly 24-hour ambulatory blood pressure monitoring (ABPM) is crucial in obtaining more reliable BP measures and is increasingly being recognized to provide additional prognostic value and guidance for adequate treatment (4). Similarly, there is increasing evidence for additional benefit for home BP monitoring. In this context, the recently published TASMINH4 trial assessing the efficacy of self-monitored BP, with or without telemonitoring, for titration of anti-hypertensive medication has potential wide ranging implications for future management of hypertension in clinical practice (5)
%U https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6382658/