Patients who control their blood pressure at home tend to have better results
The authors say that while previous studies have examined self-monitoring and self-regulation therapy TASMINH2 (the name of the last test) is the first to test the two together, and also the first to examine the large-scale self- .The control patients were reviewed by their GP (family doctor). The doctors did not put the instructions on the visit to review various medication for hypertension. Attention was then left to the discretion of the family doctor.
Dr Gbenga Ogedegbe, Center for healthy behavior change, New York University School of Medicine, United States, said in an accompanying commentary:
The patients measured their blood pressure twice every morning – five minutes of each other. They were told to act on every second reading. They had to use a type of light, green and amber be above or below the target, but always limt security, and red is outside the limits of safety.
Richard J McManus, Jonathan Mant, Emma P Bray, Roger Holder, Miren I Jones, Sheila Greenfield, Kaambwa Billingsley, Miriam Banting, Stirling Bryan, Paul Little, Bryan Williams, FD Richard Hobbs
After 12 months, systolic blood pressure was decreased by 17 6 mm Hg in the group of self-management
Patients received two training sessions on how to use their automated sphygmomanometer – a type of blood pressure monitoring – and training on how to pass on their skills in reading the research team via a modem that was connected to automatically monitor and connected to a standard telephone socket.
“Although the results of the study suggest that self-TASMINH2 titration of antihypertensive drugs is mature in terms of feasibility, safety and efficiency of its widespread use in primary care practices may be premature until ‘that these results are replicated by other researchers, especially low-income, low literacy patients receiving care in low-resource, non-academic. While we await the results of two studies that are exploring these questions, the future of remote monitoring and self-titration as a practice-based strategy for management of patients with uncontrolled hypertension, is not far ahead. ”
There were a total of 527 patients in this randomized controlled trial, of which 263 were assigned to self-management, and 264 assigned to the control group. The primary analysis consisted of all 480 patients (91% of the total 234 patients and 246 controls self-management).
Mean systolic blood pressure decreased by 12 9 mm Hg from baseline to 6 months in self-management
“Self-management is not suitable for all patients *. However, even if only 20% of people with high self-manage their condition, the figure would still represent about 4% of the UK population -. That is, more than 2 million people ”
NICE guidelines for hypertension and have been used as a basis for reading the blood pressure to the target home, mm Hg for listening 10 / 5 from the recommendations of the British Hypertension Society, as the readings at home are generally lower than the readings performed by a physician. The targets were set at home 130/85mm Hg for patients without diabetes and 130/75 mm Hg for patients with diabetes.
After 12 months, systolic blood pressure was decreased by 12 2 mmHg in the control group (group difference of 5 mm Hg 4)
A month has been confirmed above the target, four days or more readings were above target this month. After a visit to review by the patients in the intervention group and their family doctor, a program that included two drugs increases in adjustment or change of medication was organized. Blood tests for monitoring angiotensin converting enzyme (ACE) was also an option. The doctor has not received specific instructions to change the drug by the research group different guidelines by the British National Institute for Health and Clinical Excellence (NICE).
“The remote monitoring and self-management in hypertension control (TASMINH2): a randomized controlled trial”
According to a new trial, patients with (hypertension), which are trained to control their blood pressure at home, according to predetermined rules, tend to have a more significant decrease in blood pressure than patients on conventional treatment. You can read about it in the latest issue of The Lancet.
