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Research finds further evidence to place blood pressure monitoring in the hands of the patient, rather than the GP.
We implemented it at our practice and as a result of it we were able to speed up the monitoring considerably. We reduced the time patients had to wait for a monitor from what was around two to four weeks, to one to two weeks.
- Dr Christine A'Court, Oxfordshire GP.

GPs can accurately diagnose hypertension from just five days from patient self-monitoring, according to latest research findings.

Researchers compared results with the process recommended by NICE guidelines, which suggests twice-daily recordings for seven days with the first day of results discarded, and found no significant difference in accuracy.

Published in the Journal of Hypertension, the study included 247 consecutive participants with elevated systolic blood pressure (above 130mmHg) who underwent 28 days of self-monitoring, followed by 24-hours ambulatory blood pressure monitoring to provide the most accurate reference readings.  

The average reading from patients who self-monitored for two to five days was just as accurate in correctly classifying hypertension as data from up to seven days self-monitoring (correctly classifying 150 of 203 participants). In a sensitivity analysis, data was not improved by including readings beyond day five.

Self-monitoring in the clinic was more accurate than readings taken by the GP, but not self-monitoring outside of the clinic.

In a blog post about the research, lead author Dr David Nunan, Senior Research Fellow in the Nuffield Department of Primary Care Health Sciences, concluded:

“Our study showed that home monitoring is best used as a test to rule out high blood pressure and that doctors can just as accurately identify patients without high blood pressure from 5 days of self-monitoring. There’s also no need to worry about excluding readings taken on the first day.”

Dr Christine A’Court, Clinical Researcher at the University of Oxford and an Oxfordshire GP, told PULSE magazine:

“We implemented it at our practice and as a result of it we were able to speed up the monitoring considerably. We reduced the time patients had to wait for a monitor from what was around two to four weeks, to one to two weeks.

“Patients were able to pick up the manometer first thing on a Monday morning and return it on a Friday afternoon, so their whole monitoring was completed within a week and we could invite the next patient in for the following Monday.”

Further information:

Altmetric

Accuracy of self-monitored blood pressure for diagnosing hypertension in primary care.
Nunan D, Thompson M, Heneghan CJ, Perera R, McManus RJ, Ward A.
Journal of Hypertension April 2015 - Volume 33 - Issue 4 - p 755–762
doi: 10.1097/HJH.0000000000000489

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