Abstract
Hypertension describes a condition when blood vessels are under consistent raised pressure. It is the most common cause of cardiovascular disease, often leading to heart and kidney problems. With around 1.13 billion people worldwide diagnosed with it and many unaware of having it as the symptoms may be found untraceable, hypertension treatment is a rather pressing issue (“World Health Organization”, n.d.). Home blood pressure monitoring is a part of most international guidelines on treating this disease, proving to efficiently contribute to the medication regimens (George & MacDonald, 2015). The need for its introduction arose with the discovery of the limitations of the office monitoring. Even though home devices still have a way to go to become completely accurate, they have already proven their indispensability. Invoking better understanding of the disease management among patients, home monitoring leads to an increased consciousness about health and compliance with treatment courses (White, 2016). Combined with assistance from health care professionals, HBPM allows to control the state of the patient better and change the regimen when needed based on the most recent data (George & MacDonald, 2015). Still, while proving to be useful for patients diagnosed with hypertension, HBPM often leads to inaccurate measurements, provoking anxiety, excessive monitoring, or even unauthorized changes to the medication intakes (George & MacDonald, 2015). This paper will examine whether daily home blood pressure monitoring influences compliance with medication regimens for hypertension in adults who have hypertension after diagnosis.
Hypertension is the most widespread cause of cardiovascular disease nowadays. Home blood pressure monitoring (HBPM) is the tool usually introduced as a part of the course of treatment and recommended by the general guidelines (George & MacDonald, 2015). Hypertension is known to increase the risks of heart stroke or failure, kidney disease and more (George & MacDonald, 2015). Thus, HBPM offers patients an opportunity to keep track of their blood pressure on a daily basis and is considered an essential part of medication regimens. Consequently, in the framework of this paper, it will be proven that HBPM influences compliance with treatment courses in people with hypertension.
Hypertension describes a situation in which the blood vessels are consistently under raised pressure. According to the World Health Organization (WHO) (n.d.), 1.13 billion people worldwide have hypertension, and less than 1 in 5 have the problem under control. With it being a major cause of premature death and with around 2/3 cases of it discovered in low- or middle-income regions of the world, the problem of finding an effective treatment becomes crucial (“World Health Organization”, n.d.). Multiple recommendations reduce the probability of hypertension, including reducing salt, trans or saturated fats consumption, adding fruits and avoiding tobacco (Singh, Shankar, & Singh, 2017). However, all of these appear hard to follow, especially in cases of developing countries, where the nutrition issue remains the pressing one (“World Health Organization”, n.d.). Overall, hypertension is hard to track, resulting in many people living with it unaware of their condition as it often does not show any symptoms (Kitt, Fox, Tucker, & McManus, 2019). Still, this disease progresses severely among those in high-risk groups and requires thorough treatment.
Home blood pressure monitoring
The need for HBPM itself arose both from the disadvantages of the office blood pressure (BP) measurement and the discovered cost-efficiency of the home one. HBPM showed to have many other advantages, for example, taking readings over an extended time period, avoiding white-coat reactions, detecting blood pressure variability and letting patients better understand how to manage the disease (George & MacDonald, 2015). Nevertheless, there are also some limitations, such as inaccuracy, induction of anxiety and excessive monitoring, risks of medication regimen change by patients based on the normality of their BP (George & MacDonald, 2015). Besides, some of the accuracy problems come from the fact that devices themselves vary considerably – there are manual and automatic auscultatory methods, oscillometric method, tonometry, hybrid and cuffless devices (Stergiou, Parati, & Mancia, 2019). Despite the limitations HBPM demonstrates, it remains crucial in the course of hypertension treatment.
There are multiple effects home blood pressure monitoring proves to have in cases of hypertension management. First of all, it provides doctors with data on BP levels of their patients in larger time frames than possible with the use of office monitoring (White, 2016). That allows better assessment of the medication regimens’ efficiency, and, most importantly, does increase patients’ compliance with those (White, 2016). Apart from that, HBPM improves BP control for patients with uncontrolled hypertension, reduces systolic and diastolic blood pressure, as well as therapeutic inertia (George & MacDonald, 2015). It is also stressed that HBPM is most effective when it is combined with telemonitoring from a health care professional (George & MacDonald, 2015). It means that home readings are instantly checked, and medication regimen is directly affected by the changes in BP, obtained from home monitoring (George & MacDonald, 2015). While there are still limitations regarding home monitoring devices, they continue to diminish, increasing the overall importance of HBPM in the course of hypertension treatment.
References
George, J., & MacDonald, T. (2015). Home Blood Pressure Monitoring. European Cardiology, 10(2), 95–101. Web.
Kitt, J., Fox, R., Tucker, K. L., & McManus, R. J. (2019). New approaches in hypertension management: A review of current and developing technologies and their potential impact on hypertension care. Current Hypertension Reports, 21(6), 44. Web.
Singh, S., Shankar, R., & Singh, G. P. (2017). Prevalence and associated risk factors of hypertension: A cross-sectional study in urban Varanasi. International Journal of Hypertension, 2017, 5491838. Web.
Stergiou, G. S., Parati, G., & Mancia, G. (2019). Home blood pressure monitoring. Cham: Springer.
White, W. B. (Ed.). (2016). Blood pressure monitoring in cardiovascular medicine and therapeutics (3d ed.). New York, NY: Humana Press.
World Health Organization. (n.d.). Web.