Does self-monitoring and self-management of BP after stroke improve control?

  • Davison WJ & al.
  • Am Heart J
  • 27 Jul 2018

  • from Sarfaroj Khan
  • Clinical Summaries
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Takeaway

  • Self-BP monitoring (SBPM) with or without guided self-management of antihypertensive therapy was safe and well tolerated, but it did not improve overall BP control in patients with recent stroke or transient ischaemic attack (TIA).

Why this matters

  • Rate of BP control in high-risk group, especially in patients with recent stroke, is poor despite the existence of effective treatment options.

Study design

  • Randomised controlled trial of 154 patients (treatment as usual [TAU], n=52; self-monitoring only [S-MON], n=51; self-monitoring with guided self-management of BP [S-MAN], n=51) with hypertension and a recent stroke or TIA.
  • Funding: National Institute for Health Research.

Key results

  • Mean daytime ambulatory systolic BP at 6 months showed no significant between-group differences (TAU minus S-MON, 2.69 mmHg; 95% CI, −2.59 to 7.97; P=.31; TAU minus S-MAN, 3.00 mmHg (95% CI, −2.53 to 8.54; P=.28) or in mean daytime ambulatory diastolic BP.
  • SBPM did not increase the number of participants achieving target BP (daytime ambulatory BP monitoring, ≤120/75 mmHg; P>.05).
  • Number of patients with adjusted antihypertensive therapy was higher in the S-MAN group (P=.001) vs TAU group.
  • Number of dose increases was higher in the S-MAN group vs TAU group (P≤.0001).

Limitations

  • Small between-group BP difference.