According to experts, there is a practical way to monitor treatment-hypertension at home with home blood pressure monitoring. A home blood pressure monitoring (HBPM) may be a useful means of monitoring for treatment-resistant hypertension (TRH) and subsequent risk stratification.
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| Image: Home Blood Pressure Monitoring | InStyleHealth |
Furthermore, TRH and uncontrolled TRH as detected by
HBPM are linked to an increased risk of cardiovascular disease (CVD),
regardless of end-organ damage.
The study comprised 4,261 outpatients (mean age 64.9
years, 46.8% men), 91.5 percent of whom were hypertensive, whose data were
acquired from the countrywide Japan Morning-Surge Home BP study. For 14 days,
all individuals had morning and evening HBPM and were monitored for an average
of 6.2 years.
There were 270 CVDs in total, including 229
atherosclerotic CVDs. Even after correcting for potential confounding factors,
TRH, defined as a home blood pressure of 135/85 mm Hg, significantly increased
the risk of total CVD events compared to non-TRH (adjusted hazard ratio [HR],
1.72, 95 percent confidence interval [CI], 1.27–2.35).
When the definition of TRH was revised to home BP
130/80 mm Hg (adjusted HR, 1.69, 95 percent CI, 1.30–2.26) and home BP 125/75
mm Hg (adjusted HR, 1.65, 95 percent CI, 1.24–2.20), a comparable effect was
observed.
"Home blood pressure monitoring has been
suggested as a tool for risk classification in TRH patients. However, more
research is needed to see if managing home blood pressure control in people
with TRH will help avoid CVD events, according to the researchers.
"Intervention studies will be required to assess
this concern in clinical practice." Furthermore, novel strategies for the
management of uncontrolled TRH should be devised, such as new medicines, diet
and exercise treatment, or denervation therapy," experts noted.