Home BP Monitoring ‘More Important Than Ever’ During Pandemic

Keep screening for hypertension, the U.S. Preventive Services Task Force (USPSTF) reiterated in draft guidelines, while other groups urged home blood pressure monitoring as well.

The USPSTF gave a grade A recommendation to in-office screening for hypertension in adults with confirmation outside of the clinical setting before starting treatment. The draft recommendations — open for public comment until July 20 — match the group’s 2015 final recommendations, but buttressed with additional research from the past 5 years.

A separate joint policy statement from the American Heart Association and American Medical Association (AHA/AMA) affirmed that self-measured blood pressure (SMBP) at home is a validated approach and cost effective when added to office monitoring.

“With fewer patients visiting medical offices during the COVID-19 pandemic, SMBP monitoring is more important than ever for people at risk for hypertension and uncontrolled BP,” statement chair Daichi Shimbo, MD, of Columbia University Medical Center in New York City, said in a press release.

Twenty-four-hour ambulatory BP monitoring may be the gold standard, but it’s often not available outside of specialty hypertension centers, noted the AHA/AMA statement, which was published in the journal Circulation.

“SMBP monitoring is not only convenient for patients — it is superior to in-office BP measurements for predicting cardiovascular events,” Shimbo added.

Validated home BP devices that use the oscillometric method are preferred, his group added, and a standardized BP measurement and monitoring protocol should be followed, with readouts printed or electronically sent to the care team.

In practical terms, the statement supported use of automatic home blood pressure cuffs that don’t require manual inflation, that involve the upper arm rather than the wrist, and that are appropriately sized, which isn’t the standard adult cuff for more than half of men and nearly 40% of women in the United States.

Of note, in-office and self-measured blood pressure readings are not always interchangeable. The statement pointed out that a self-measured blood pressure of 135/85 mm Hg corresponds to an office measurement of 140/90 mm Hg, and 145/90 at home corresponds to 160/100 mm Hg in office, as had been indicated in the 2017 hypertension guidelines.

Disclosures

Shimbo disclosed no relevant relationships with industry.