Hypertensive Patients Lower Systolic Blood Pressure with Self-regulation of Medications

Written by on October 31, 2014 in Research & Technology - No comments

A randomized clinical trial shows that self-surveillance and self-adjustment of anti-hypertensive therapy in hypertensive patients resulted in lower systolic blood pressure after one year compared to traditional treatment.

Hypertensive subjects at high risk of cardiovascular disease were able to reduce their systolic blood pressure after 12 months with self-monitoring and self-adjustment of medications, versus usual care given by primary care physicians, according to the findings of a randomized clinical trial.

Richard J. McManus, FRCGP and colleagues at the University of Oxford in Oxfordshire, UK published the results of their Targets and Self-Management for the Control of Blood Pressure in Stroke and at Risk Groups (TASMIN-SR) trial in the August 27, 2014 issue of the Journal of the American Medical Association.

BP-cuffWEBA previous study found that self-management of hypertension resulted in significantly lower systolic blood pressure after 1-year vs ordinary care. However, this study had few patients with high- risk illnesses, like cardiovascular disease, and their blood pressure reduction was less. The current study was designed to address these high-risk patients, specifically.

A total of 555 hypertensive patients above age 35 with at least 1 of the high-risk conditions (cardiovascular disease, diabetes, or stage 3 chronic kidney disease) were randomized to receive usual care (278) or the intervention (220).

Primary outcome data were obtained from 450 patients (81%). After 1 year, the intervention group had a reduction in their systolic blood pressure of 9.2 mm Hg more than the control group (95% CI, 5.7-12.7).  In addition, for the same period of time, the intervention group had a reduction of 3.4 mm Hg in their diastolic blood pressure more than the control group (95% CI, 1.8-5.0). There were no significant adverse effects.

“This study has shown that self-monitoring with self-titration of antihypertensives is feasible and achievable in a high-risk population without special equipment and by following a modest amount of training and additional family physician input”, the authors concluded.

This study was conducted independently and funded by the National Institute for Health Research.

By Alexis Gopal MD

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