Studies demonstrate the benefits of self-measurements

Self measurement at the wrist

Our service BloodPressureDB is designed for the collection and management of the blood pressure values measured by you at home or on the go. These can be transmitted in processed form via the PDF evaluation to your treating physician.

Various studies demonstrate how valuable the values you measure and our service are in the adjustment and control of a hypertension. Incorporating self-measurements into the therapy decision facilitates this and allows for a more differentiated prescription of medication. Additionally, the target blood pressure is usually reached more quickly this way.

How important good blood pressure control is, given the looming complications such as heart attack and stroke - to name just two - is easy to recognize. Unfortunately, worldwide, only about 30 percent of known hypertensives have their blood pressure well controlled. In Germany, the rate is unfortunately much lower.

1. American Study from 2022

Dr. Beverly Green from the Washington Permanente Medical Group in Seattle and her team compared measurements in the clinic with measurements at home and measurements at blood pressure measurement stations such as pharmacies. All participants also underwent 24-hour measurements for comparison. They included 500 patients.

The results showed that blood pressure values in clinics were slightly too low and at measurement stations slightly too high. Home measurements performed the best. These were conducted as recommended by the High Blood Pressure League in the guidelines and as instructed by the BloodPressureDB app.

2. Study from the Nephrology Center Göttingen

A study from the Nephrology Center Göttingen showed a significant improvement in hypertension control using telemetric technology compared to care in the specialized outpatient clinic for hypertensive patients, which also has high success rates. For the study, a portion of the patients was equipped with a telemetry unit (blood pressure monitor and Bluetooth-enabled mobile phone) and instructed to measure and record their blood pressure in the morning. However, not all measured values were transmitted, only those that exceeded a previously set alarm threshold. These alarm rules were specifically developed for this study and represent a global innovation.

Verification was done through a 24-hour blood pressure measurement at the beginning and end of the study after three months. The target blood pressure could be achieved in this time for 54 percent of the telemetry group. In comparison, only 35 percent of the control group achieved this result.

The study leader, Dr. Egbert Schulz, sees the reason for this success, in addition to better therapy adherence, primarily in the optimized therapy, which is facilitated by the automatically transmitted, reliably measured blood pressure data from the patient.

3. English Study Published in February 2018

Self measurement at the upper arm

An English study with nearly 1,200 participants also demonstrated the benefits of home self-measurement (especially with telemetric data transmission as possible with BloodPressureDB).

The duration of the study was set for twelve months. The participants were divided into three groups.

One part - the control group - had their blood pressure checked only at the doctors office as before. Another part - the intervention group - measured their blood pressure in the morning and evening with a suitable measuring device at home and submitted the data to their family doctor at the end of each week. The third part - the telemetry group - also performed home self-measurements. Additionally, the data were transmitted telemetrically or via SMS in processed form (similar to the PDF evaluation from BloodPressureDB) to the family doctor. The doctor was instructed to check the values monthly. Moreover, the system would alert in case of missing or extreme blood pressure values.

At the end of the duration, it was found that the systolic value of the participants who self-measured their blood pressure at home was significantly lower than that of those whose blood pressure was only checked in the doctor's office.

The telemetry group achieved the greatest success. The blood pressure reduction of individuals with telemonitoring was even slightly stronger than in the intervention group. Most importantly, it could be achieved earlier than in the comparison groups. Compared to the control group - those whose blood pressure was only measured in the doctor's office - the significant advantage was already evident after six months.

As decisive for this development, the better adjustment of the medication dosage or composition was also seen here. This is partly possible because home self-measurements eliminate the white coat effect in the doctor's office. This effect leads to higher measured values in the doctor's office due to (possibly also unconscious) tension than is the case in normal daily life. For this reason, according to the conducting scientists, target blood pressure values for home self-measurements should be set 5 mmHg below those valid in the doctor's office.

4. American Pilot Study

For this study, 2,550 participants were provided with blood pressure monitors for home use. The participants had previously suffered from persistent (= inadequately controlled) hypertension. They monitored their blood pressure for the study in addition to regular checks at the doctors office through self-measurements in their daily lives. Their measured values were transmitted online or in printed form to the treating physicians. These were included in the study and knew that the participants had received a measuring device for home measurement and had also been trained in its use. 67 percent of the participants managed to get their blood pressure under control by the third visit to the practice. By the sixth visit, this number had dropped to 60 percent. This is due to some participants reaching their target blood pressure soon after incorporating home measurements into the therapy decision. The medication was thus quickly adjusted successfully, allowing for a reduction or elimination of checks in the practice.

After six months, nearly 80 percent of all participants had reached their target blood pressure. According to the strict guidelines of the American Heart Association (AHA), blood pressure was well controlled in 72 percent of the participants at the end of the six months. On average, systolic blood pressure decreased by 16.9 mmHg and diastolic blood pressure by 6.5 mmHg. Self-measurement saved each participant an average of one to two doctor visits annually.

5. Meta-Analysis of 52 Studies on This Topic

Evaluation of Self measurements with App

The results of a meta-analysis were published in the Annals of Internal Medicine. The researchers analyzed a total of 52 prospective comparative studies on antihypertensive therapy. They compared conventional treatment of hypertension, where no further checks were made, with therapy support through self-measurements. Participants received support in the form of consultations, training, or instructions.

After six months, the self-measuring group showed a significant improvement in blood pressure values compared to the conventionally treated group. Unfortunately, this advantage was not as clearly evident after twelve months. However, if the participants who measured their blood pressure themselves in daily life received support as described above, the significant advantage persisted even after twelve months.

Overall, this meta-analysis also demonstrates the benefits of independent blood pressure measurements. The risk of over- or under-dosing medications decreases, and the trend curve through regular measurements allows the doctor to better tailor the medication individually.

6. Japanese Study from November 2022

A study published in February 2023 in Hypertension compared the predictive capabilities of cardiovascular diseases from 24-hour blood pressure measurements and regular home blood pressure measurements in the morning and evening. It was found that regular measurements at home could better reflect the risk of cardiovascular diseases than long-term blood pressure measurement.

These studies make it clear how much the affected individual can do to enable the most effective therapy adjustment possible. Self-measurement is an important tool in the adjustment and control of hypertension. The benefits are further enhanced by telemetric transmission of the values, as is possible with BloodPressureDB. An increase or a too strong drop in blood pressure can be quickly recognized and the medication dosage adjusted.

7. Swedish Study Published in July 2023

In this study, the researchers had over 5,000 participants measure their blood pressure three times each morning and evening at home for a week. It was particularly important that this was done with the same device used to measure blood pressure in the practice. Masked hypertension was found in every 20th participant. Other risk factors for cardiovascular diseases considered in this study, such as elevated fasting blood sugar levels, lower HDL cholesterol levels, and certain inflammatory parameters, were also detectable in these participants. The researchers conclude that home-measured blood pressure values are a better indicator of the risk of cardiovascular diseases than those measured in the practice.

8. Study on Visit-to-Visit Variability

A study published in March 2023 deals with the influence of blood pressure fluctuations between doctor visits. In English, this is referred to as Visit-to-Visit Variability or VVV for short. This indicates how much blood pressure can fluctuate between two doctor visits. These natural fluctuations make it difficult to assess the effectiveness of medications or other measures. The study examined 537,218 patients with 7,721,864 measurements. It concludes that four doctor visits would be necessary to recognize that a medication that lowers blood pressure by 10 mmHg is actually effective.

Our Recommendation

For good blood pressure control, accurate measurement is very important. Our app BloodPressureDB helps with this. Concrete explanations guide you through guideline-compliant measurement. The app also reminds you of this if desired. These functions are also fully available in the free version.

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Sources:

By Horst Klier. This article is medically reviewed. Last updated (06/2024).
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