Self-monitoring of blood pressure in patients with hypertension related multi-morbidity: Systematic review and individual patient data meta-analysis
<p><strong>Background:</strong><br /> Studies have shown that self-monitoring of blood pressure (BP) is effective when combined with co-interventions, but its efficacy varies in the presence of some co-morbidities. This study examined whether self-monitoring can reduce clinic...
| Main Authors: | , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Oxford University Press
2019
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| _version_ | 1826284160647430144 |
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| author | Sheppard, J Tucker, K Davison, W Stevens, R Heneghan, C Hill, N Hobbs, F McManus, R |
| author_facet | Sheppard, J Tucker, K Davison, W Stevens, R Heneghan, C Hill, N Hobbs, F McManus, R |
| author_sort | Sheppard, J |
| collection | OXFORD |
| description | <p><strong>Background:</strong><br />
Studies have shown that self-monitoring of blood pressure (BP) is effective when combined with co-interventions, but its efficacy varies in the presence of some co-morbidities. This study examined whether self-monitoring can reduce clinic BP in patients with hypertension-related co-morbidity.</p><br />
<p><strong>Methods:</strong><br />
A systematic review was conducted of articles published in Medline, Embase, and the Cochrane Library up to January 2018. Randomized controlled trials of self-monitoring of BP were selected and individual patient data (IPD) were requested. Contributing studies were prospectively categorized by whether they examined a low/high-intensity co-intervention. Change in BP and likelihood of uncontrolled BP at 12 months were examined according to number and type of hypertension-related co-morbidity in a one-stage IPD meta-analysis.</p><br />
<p><strong>Results:</strong><br />
A total of 22 trials were eligible, 16 of which were able to provide IPD for the primary outcome, including 6,522 (89%) participants with follow-up data. Self-monitoring was associated with reduced clinic systolic BP compared to usual care at 12-month follow-up, regardless of the number of hypertension-related co-morbidities (−3.12 mm Hg, [95% confidence intervals −4.78, −1.46 mm Hg]; P value for interaction with number of morbidities = 0.260). Intense interventions were more effective than low-intensity interventions in patients with obesity (P < 0.001 for all outcomes), and possibly stroke (P < 0.004 for BP control outcome only), but this effect was not observed in patients with coronary heart disease, diabetes, or chronic kidney disease.</p><br />
<p><strong>Conclusions:</strong><br />
Self-monitoring lowers BP regardless of the number of hypertension-related co-morbidities, but may only be effective in conditions such obesity or stroke when combined with high-intensity co-interventions.</p> |
| first_indexed | 2024-03-07T01:09:42Z |
| format | Journal article |
| id | oxford-uuid:8c92cb4a-8427-4dfa-8119-29f5406d8aaf |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T01:09:42Z |
| publishDate | 2019 |
| publisher | Oxford University Press |
| record_format | dspace |
| spelling | oxford-uuid:8c92cb4a-8427-4dfa-8119-29f5406d8aaf2022-03-26T22:45:29ZSelf-monitoring of blood pressure in patients with hypertension related multi-morbidity: Systematic review and individual patient data meta-analysisJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:8c92cb4a-8427-4dfa-8119-29f5406d8aafEnglishSymplectic Elements at OxfordOxford University Press2019Sheppard, JTucker, KDavison, WStevens, RHeneghan, CHill, NHobbs, FMcManus, R<p><strong>Background:</strong><br /> Studies have shown that self-monitoring of blood pressure (BP) is effective when combined with co-interventions, but its efficacy varies in the presence of some co-morbidities. This study examined whether self-monitoring can reduce clinic BP in patients with hypertension-related co-morbidity.</p><br /> <p><strong>Methods:</strong><br /> A systematic review was conducted of articles published in Medline, Embase, and the Cochrane Library up to January 2018. Randomized controlled trials of self-monitoring of BP were selected and individual patient data (IPD) were requested. Contributing studies were prospectively categorized by whether they examined a low/high-intensity co-intervention. Change in BP and likelihood of uncontrolled BP at 12 months were examined according to number and type of hypertension-related co-morbidity in a one-stage IPD meta-analysis.</p><br /> <p><strong>Results:</strong><br /> A total of 22 trials were eligible, 16 of which were able to provide IPD for the primary outcome, including 6,522 (89%) participants with follow-up data. Self-monitoring was associated with reduced clinic systolic BP compared to usual care at 12-month follow-up, regardless of the number of hypertension-related co-morbidities (−3.12 mm Hg, [95% confidence intervals −4.78, −1.46 mm Hg]; P value for interaction with number of morbidities = 0.260). Intense interventions were more effective than low-intensity interventions in patients with obesity (P < 0.001 for all outcomes), and possibly stroke (P < 0.004 for BP control outcome only), but this effect was not observed in patients with coronary heart disease, diabetes, or chronic kidney disease.</p><br /> <p><strong>Conclusions:</strong><br /> Self-monitoring lowers BP regardless of the number of hypertension-related co-morbidities, but may only be effective in conditions such obesity or stroke when combined with high-intensity co-interventions.</p> |
| spellingShingle | Sheppard, J Tucker, K Davison, W Stevens, R Heneghan, C Hill, N Hobbs, F McManus, R Self-monitoring of blood pressure in patients with hypertension related multi-morbidity: Systematic review and individual patient data meta-analysis |
| title | Self-monitoring of blood pressure in patients with hypertension related multi-morbidity: Systematic review and individual patient data meta-analysis |
| title_full | Self-monitoring of blood pressure in patients with hypertension related multi-morbidity: Systematic review and individual patient data meta-analysis |
| title_fullStr | Self-monitoring of blood pressure in patients with hypertension related multi-morbidity: Systematic review and individual patient data meta-analysis |
| title_full_unstemmed | Self-monitoring of blood pressure in patients with hypertension related multi-morbidity: Systematic review and individual patient data meta-analysis |
| title_short | Self-monitoring of blood pressure in patients with hypertension related multi-morbidity: Systematic review and individual patient data meta-analysis |
| title_sort | self monitoring of blood pressure in patients with hypertension related multi morbidity systematic review and individual patient data meta analysis |
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