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Effect of home blood pressure monitoring for blood pressure control in hypertensive patients taking multiple antihypertensive medications including fimasartan (the FORTE study)

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Authors
Choi, Jung-Yeon; Kim, Kwang-il; Kim, Cheol-Ho
Issue Date
2020-12-15
Publisher
BMC
Citation
Clinical Hypertension. 2020 Dec 15;26(1):24
Keywords
Blood pressureHypertensionKorea
Abstract
Background
Although recent hypertension guidelines recommend home blood pressure (HBP) monitoring, its effect in clinical practice is not well known. This study aimed to identify current HBP measurement status and obstacles and their efficacy on blood pressure (BP) control.

Methods
Sixty-three intervention and 61 control centers with 2483 (mean age: 58.0 years, 56.0% male) drug-naïve stage 2 hypertensive patients or patients requiring second anti-hypertensive medications were included. The intervention group was instructed to measure HBP twice a day for 7 days from the scheduled visit at 4, 8, and 12 weeks.

Results
At the end of 12 weeks, 842 (68.7%) and 807 (64.15%) patients of the control and intervention groups, respectively, achieved a target BP. The odds ratio (OR) for improving BP control of HBP was 0.836 (95% confidence interval [CI]: 0.694–1.007). Among intervention group, clinic BP of the subgroup those measured their HBP at least once well controlled compared to subgroup those not measured their HBP at all (OR 1.602, 95% CI: 1.182–2.172). Only 19.17% (n = 476) had a home sphygmomanometer, and among those, 26.89% measured their BP at least once a week and 34.87% did not measure the BP at all. The obstacles of HBP measurement were lack of awareness of its importance (40.83%), lack of confidence on how to measure BP and maintain the measurement (37.04%), and difficulty in selecting an appropriate device (14.41%).

Conclusions
HBP measurement alone did not improve BP control, but better compliance with the HBP measurement resulted in improved BP control.

Trial registration
ClinicalTrials,
NCT03254914

, Registered 21 August 2017.
ISSN
2056-5909
Language
English
URI
https://hdl.handle.net/10371/173592
DOI
https://doi.org/10.1186/s40885-020-00154-y
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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