and transmitted securely. Federal government websites often end in .gov or .mil. Rockville, MD 20857 First, a health care professional wraps an inflatable cuff around your arm. Unauthorized use of these marks is strictly prohibited. PMC The cost of a home BP monitor ranges between $40 to $150, and the insurance coverage and approval for these devices vary across states.33 However, provision of the device could be cost-saving if it resulted in a reduced number of office visits for BP measurement or management or resulted in improved BP, which could translate into reduced morbidity and health care utilization. 45.) To accelerate SMBP use, the Centers for Disease Control and Prevention (CDC) funded the National . Randomized-controlled trials have shown that self-measured blood pressure predicts cardiovascular morbidity and mortality better than office BP measurements. Clinic measurements may not reflect the usual BP outside of the clinic setting throughout a day. Using SMBP to guide you in diagnosing and treating hypertension likely will produce better outcomes than using office blood pressure readings alone. The bold lines correspond to the comparisons covered in this report: SMBP versus usual care (Key Question 1, part 1); SMBP plus additional support versus support without SMBP (also Key Question 1, part 1); SMBP plus additional support versus usual care (Key Question 1, part 2); SMBP plus additional support versus SMBP (Key Question 2). Strategies aimed at the control of high BP as well as adherence to medication continue to be of foremost concern to providers and patients, health care payers, policymakers, and governments worldwide. In people with hypertension (adults and children), does self-measured blood pressure (SMBP) monitoring, compared with usual care or other interventions without SMBP, have an effect on clinically important outcomes? Telephone: (301) 427-1364, Powered by the Evidence-based Practice Centers, Self-Measured Blood Pressure Monitoring: Comparative Effectiveness, https://effectivehealthcare.ahrq.gov/products/measuring-blood-pressure, Comment on Key Questions and Draft Reports, 25 Years of the AHRQ Evidence-based Practice Center Program, U.S. Department of Health & Human Services. Rockville (MD): Agency for Healthcare Research and Quality (US); 2012 Jan. Report No. Self-blood pressure monitoring, by itself, has been shown to be an effective tool in predominantly white populations, but less studied in minority, urban communities. Self-Measured Blood Pressure Monitoring: Action Steps for Public Health Practitioners. Readings by a person can be affected by observer training, preference, and bias. Self-measured blood pressure (SMBP) has been used in the treatment of hypertension with three major aims: 1) to avoid undertreatment of hypertension 2) to enhance self-participation in disease management and to enhance adherence; and 3) to avoid overtreatment in those with lower BP out of the clinic compared with in the clinic 26 The .gov means its official. Home BP monitoring (HBPM) has been utilized for regular monitoring of BP at home to improve HTN control or regulate antihypertensive medications. Why do I need to measure my blood pressure? Purpose This summary is provided to assist in clinical decisionmaking along with consideration of a patient's values and preferences. Centers for Disease Control and Prevention. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2013. In total, 49 studies met eligibility criteria. With training, additional support and treatment algorithms, patients may be able to self adjust medications based on SMBP results. The site is secure. Details on design, patients, interventions, outcomes, and quality were extracted into standard forms. Patients may require some instruction on how to use SMBP devices.30,31. Future research should standardize patient inclusion criteria, BP treatment targets for home BP, and SMBP and additional support protocols to maximize the interpretability and applicability of SMBP trials. 2011 Jan-Feb;46(1):99-102. doi: 10.4085/1062-6050-46.1.99. Self Measured Blood Pressure Monitoring (SMBP), the self measurement of blood pressure (BP) outside of the health care setting may be an effective tool to facilitate BP control. How to Measure Your Blood Pressure at Home [PDF 255 KB] Content last reviewed August 2018. Talk with your health care team about regularly measuring your blood pressure at home, also called self-measured blood pressure (SMBP) monitoring. Self-Measured Blood Pressure Monitoring . SMBP with or without additional support may confer a small benefit in BP control compared with usual care, but the BP effect beyond 12 months and the attendant long-term clinical consequences remain unclear. Self-measured blood pressure (SMBP) has been used in the treatment of hypertension with three major aims: 1) to avoid undertreatment of hypertension 2) to enhance self-participation in disease management and to enhance adherence; and 3) to avoid overtreatment in those with lower BP out of the clinic compared with in the clinic26, SMBP is being used to avoid undertreatment of hypertension. An Opportunity to Better Address Hypertension in Women: Self-Measured Blood Pressure Monitoring Million Hearts Science team, Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GeorgiaDisclosure: Allison Goldstein, MPH, has disclosed no relevant financial relationships. This feature requires the newest version of Flash. To address comparative effectiveness, we included prospective comparative studies of SMBP with or without additional support versus usual care or an alternative SMBP intervention. pharmacists and nurse practitioners) to manage patients' HBP (Figure 1). There were 24 comparisons of SMBP alone versus usual care, 24 of SMBP plus additional support versus usual care, 12 of SMBP plus additional support versus SMBP without additional support or with less intense additional support, and 1 study evaluating predictors of adherence to SMBP. The current report evaluates ambulatory BP monitoring only as an outcome measurement tool, not as an intervention of interest. Self-measured blood pressure (SMBP) monitoring, the regular measurement of blood pressure (BP) by the patient at home, has been proposed as a means of improving treatment adherence and BP control. Associate Director, Center for Health Services Research in Primary Care Durham Veterans Affairs Medical Center To determine predictors of adherence with SMBP monitoring. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. MEDLINE, Cochrane Central Register of Controlled Trials, existing systematic and narrative reviews, recent conference proceedings, and the Food and Drug Administration. SMBP monitoring can provide more frequent BP readings and if these are transmitted back to the provider, they can be used for more rapid and frequent adjustments in blood pressure medication to ensure adequate BP control. Clinical support includes regular one-on-one counseling, web-based or telephonic support tools, and educational classes. 8. Please use this form to submit your questions or comments on how to make this article more useful to clinicians. Past forum recordings, slides, and other resources can be found on the SMBP ForumConfluence page. Effective BP control has been shown to decrease incidence for stroke by 35 to 40 percent, myocardial infarction by 20 to 25 percent, and heart failure more than 50 percent.11,12 Systematic reviews have also shown the beneficial effects of lowering BP on reducing fatal and nonfatal stroke, cardiac events, and total among individuals with severe hypertension or at increased risk (such as of older age or with other comorbid risk factors).11,13,14 A decrease of 5 mmHg in systolic BP has been estimated to result in a 14 percent overall reduction in mortality due to stroke, 9 percent reduction in mortality due to chronic heart disease and 7 percent reduction in all-cause mortality.1,15,16 However, long-term adherence to lifestyle modification and medication remains a challenge in the management of hypertension, which is usually a lifelong condition. This site needs JavaScript to work properly. ECG Challenge: What's Causing This Woman's Slow Pulse? CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Resources for Public Health Professionals, Improving Medication Adherence Among Patients with Hypertension, Hypertension Control Challenge Rules and Eligibility, Hypertension Control Champions Success Stories, Hospitals & Health Systems Recognition Program, Spotlight: NYC Health + Hospitals/Metropolitan, Spotlight: The Ohio State University and Wexner Medical Center, Spotlight: New Hanover Regional Medical Center, COVID-19 and Cardiovascular Disease Partner Toolkit, Heart-Healthy Steps Campaign Partner Toolkit, "Live to the Beat" Campaign Partner Toolkit, Self-Measured Blood Pressure (SMBP) Monitoring Implementation Toolkit [PDF - 2 MB], U.S. Allison is trained as an emergency medical technician and received a bachelor of science degree in biology and anthropology from the University of Michigan and a master of public health degree, with a focus in behavioral science and education, from Emory University. Providers can help with SMBP implementation by promoting SMBP to their hypertensive patients and establishing clinical feedback systems. To review the role of self-measured blood pressure (SMBP) monitoring with or without additional support (interventions such as telemonitoring, counseling, education, Web support, behavioral interventions, home visits, etc.) Systematic Review: Centers for Disease Control and Prevention. Several national and international hypertension guidelines endorse self-measured BP monitoring. Current settings for BP measurement include BP measurement in a healthcare setting, or BP measurement in a patient's usual environment with either ambulatory BP monitoring, or self-measured BP (SMBP) monitoring. Tools to Establish a Self-Measured BP (SMBP) Monitoring Program [PDF 2 MB] Balk has over 125 publications on systematic reviews of a broad range of medical, surgical, health, and nutrition topics. This video from the NACHC features Natalia, a patient who explains how she has taken control of her blood pressure with SMBP monitoring. Figure 2. High blood pressure usually has no warning signs or symptoms, and many people do not know they have it. Self-Measured Blood Pressure Monitoring Program: Engaging Patients in Self-Measurement [PDF 1.5 MB] The .gov means its official. endstream
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A BP cuff is placed around the upper arm and left in place for approximately 24 hours. This graphic from Target: BP demonstrates how to prepare for a blood pressure reading, the correct position to take your own blood pressure, and how to measure it. These cookies may also be used for advertising purposes by these third parties. SMBP plus clinical support can improve access to care and quality of care for people with hypertension while making blood pressure control more convenient and accessible across the population. John M. Eisenberg Center for Clinical Decisions and Communications Science. in the management of hypertension, a systematic review of 49 studies examined the comparative effectiveness and adherence Measuring your blood pressure is the only way to know whether you have high blood pressure. Possible comparisons between SMBP, SMBP plus additional support, support without SMBP, and usual care, Agency for Healthcare Research and Quality (US). The population of interest is the general population of people with hypertension, excluding pregnant women or those receiving dialysis. Public Information from the CDC and Medscape. Content last reviewed March 2021. Blood Pressure Validated Device Listing (VDL), Self-Measurement: How Patients and Care Teams Are Bringing Blood Pressure to Control, An Economic Case for Self-Measured Blood Pressure (SMBP) Monitoring [PDF - 156 KB], Choosing-a-Home-BP-Monitor At-a-Glance-Comparison, Self-Measured Blood Pressure Monitoring: Key Findings from a National Health Information Technology Landscape Analysis, Tools to Establish a Self-Measured BP (SMBP) Monitoring Program, Self-Measured Blood Pressure Monitoring Program: Engaging Patients in Self-Measurement, Oscillometric Blood Pressure Devices Validated for Accuracy During Pregnancy, Target: BP: CME Course: Using SMBP to Diagnose and Manage High Blood Pressure, Self-Measured Blood Pressure Monitoring: Action Steps for Clinicians, Collaborative Care Models for Improving Hypertension Control Through SMBP Monitoring, Accelerating Use of Self-measured Blood Pressure Monitoring (SMBP) Through Clinical-Community Care Models, Self-Measured Blood Pressure Monitoring: Action Steps for Public Health Practitioners, Topline Findings: A National Analysis of Self-Measured Blood Pressure Monitoring Coverage and Reimbursement, CDCs 6|18 Initiative: Accelerating Evidence into Action, Release the Pressure Self-Measured Blood Pressure (SMBP) Training Video, How to Use Your Home Blood Pressure Monitor, Taking Control of My Blood Pressure: DAngelos Story, Taking Control of My Blood Pressure: Natalias Story, How to Measure Your Blood Pressure at Home, The Correct Way to Measure Blood Pressure, How Do We Jump-Start Self-measured Blood Pressure Monitoring in the United States?
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