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A connected monitor is preprogrammed to regularly record BP, usually every 15 to 20 minutes while awake and every 20 to 30 minutes while asleep. Many have undergone validation according to the recommendations of the American Association of Medical Instrumentation, the European Society of Hypertension or the British Hypertension Society.25,29 Generally, the use of validated devices is preferred. Archived: This report is greater than 3 years old. CDCs 6|18 Initiative: Accelerating Evidence into Action hb```f`` & B,@Q+g~ Rockville (MD): Agency for Healthcare Research and Quality (US); 2007. AHRQ Publication No. Self-measured blood pressure (SMBP) monitoring, the regular measurement of blood pressure (BP) by the patient at home, has been proposed as a means of improving treatment adherence and BP control. 2013 Aug 6;159(3):185-94. doi: 10.7326/0003-4819-159-3-201308060-00008. Project Timeline. J Athl Train. SMBP differs from clinic-based and ambulatory blood . Purpose Generate prioritized topics for future research on SMBP, building on evidence gaps identified in a prior comparative effectiveness review and following an . sX Ndb`T~ The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Division for Heart Disease and Stroke Prevention. The figure shows a schematic of possible comparisons between SMBP, SMBP plus additional, support without SMBP, and usual care. In brief, ambulatory BP monitoring is a noninvasive, fully automated technique in which BP is recorded over an extended period of time, typically 24 hours. How to Use Your Home Blood Pressure Monitor No matter your age, you also can take steps each day to help keep your blood pressure in a healthy range. Hypertension also imposes a heavy financial burden on society at large. The bold lines indicate the comparisons addressed in the Key Questions (see below). Self-Measured Blood Pressure Monitoring Definition and Indications SMBP plus additional clinical support is one alternative to traditional oce care that could improve access to care and quality of care for individuals with hypertension while making blood pressure control more convenient and accessible across the population. Nonpharmacologic Interventions for Treatment-Resistant Depression in Adults. https://effectivehealthcare.ahrq.gov/products/measuring-blood-pressure. 12-EHC002-EF. Content last reviewed March 2021. No studies evaluated children. In addition, ambulatory BP monitoring is often used in research studies as an outcome, since many consider it to be more accurate than clinic-based BP measurement. Past forum recordings, slides, and other resources can be found on the SMBP ForumConfluence page. Uhlig K, Balk EM, Patel K, et al. Would you like email updates of new search results? is a member of the Million Hearts Science team with the Centers for Disease Control and Prevention (CDC) Division for Heart Disease and Stroke Prevention. PMC The .gov means its official. Cookies used to make website functionality more relevant to you. To summarize evidence about the effectiveness of self-measured blood pressure (SMBP) monitoring in adults with hypertension. Use this list of questions to ask your health care team [PDF 173 KB]to help you manage your blood pressure. 2013 Aug 6;159(3):185-94. doi: 10.7326/0003-4819-159-3-201308060-00008. (Prepared by the Tufts Evidence-based Practice Center under Contract No. Updated Hypertension Guidelines: Implications for Treatment? This patient-friendly video from the Release the Pressure Coalition highlights the key steps people can take for accurate SMBP monitoring. The full report, listing all studies, is available at www.effectivehealthcare.ahrq.gov/selfmeasuredbp.cfm. Self-measured BP monitoring, the measurement of BP by an individual outside of the office at home, is a validated approach for out-of-office BP measurement. SMBP Coverage Insights: Medicaid [PDF 232 KB] 45. The choice of treatment is largely dependent on the cause of hypertension, severity of the condition, as well as the presence or absence of existing comorbid states. Current settings for BP measurement include BP measurement in a healthcare setting, or BP measurement in a patient's usual environment with either ambulatory BP monitoring, or self-measured BP (SMBP) monitoring. A reading that says your blood pressure is lower than it actually is may give you a false sense of security about your health. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. For SMBP plus additional support versus SMBP alone or with less intense additional support, the strength of evidence is low, failing to support a difference in BP. Rockville, MD: Agency for Healthcare Research and Quality. Patient-provider feedback loop.Source:Centers for Disease Control and Prevention. One study estimated that the global prevalence of hypertension in 2000 was 26 percent in the adult population. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. The gauge uses a unit of measurement called millimeters of mercury (mmHg) to measure the pressure in your blood vessels. Taking Control of My Blood Pressure: DAngelos Story Introduction. Take this form [PDF 105 KB]with you on your first blood pressure visit to record important blood pressure-related information. 5600 Fishers Lane The review addressed SMBP monitoring performed by the patient or the patient's companion at home; it did not include monitoring done at the doctor's office, clinic, pharmacy, or health unit at work, nor did it include blood pressure (BP) monitoring done at home by nurses or other health care professionals. Rockville, MD 20857 In: Comparative Effectiveness Review Summary Guides for Clinicians [Internet]. All information these cookies collect is aggregated and therefore anonymous. There are also a variety of kiosks available in stores and pharmacies. Share this graphic with family and friends to show them the correct way to measure blood pressure. Self-Measured Blood Pressure Monitoring Program: Engaging Patients in Self-Measurement [PDF 1.5 MB] Centers for Disease Control and Prevention. Allison Goldstein, MPH, If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. Thank you. To systematically review the trial evidence on the comparative effectiveness of hypertension management with versus without SMBP monitoring, and of different additional support interventions with SMBP. Types of clinical support include one-on-one counseling, Web-based and telephone support, and educational classes. and transmitted securely. As self-measurement requires patient participation, certain patient characteristics may affect compliance with SMBP monitoring, such as the willingness and ability to self-monitor BP and the technical literacy in operating the device or an interface for telemonitoring. In: Comparative Effectiveness Review Summary Guides for Clinicians [Internet]. Study Selection: . SMBP Health IT Checklist [PDF 136 KB] This report can help policymakers learn more about which payers have programs that cover and reimburse for SMBP monitoring. Newer SMBP devices can automatically store readings and some are equipped to electronically transmit readings to a provider. : 14-05198-EF-1. For all comparisons, evidence for clinical outcomes was insufficient; for all other outcomes (surrogate and intermediate outcomes, and health care encounters) strength of evidence was low, thus failing to support a difference. Self-measured blood pressure monitoring in the management of hypertension: a systematic review and meta-analysis. This process is quick and painless. This report focuses on SMBP monitoring as a strategy to help patients and clinicians to better manage and control hypertension while avoiding under- or overtreatment or treatment-related hypotension. Take at least two readings, 1 or 2 minutes apart. The site is secure. SMBP CPT Coding [PDF 1 MB] Purpose Possible comparisons between SMBP, SMBP plus additional support, support without SMBP, and usual care, Agency for Healthcare Research and Quality (US). Many SMBP devices are commercially available. Details on design, patients, interventions, outcomes, and quality were extracted into standard forms. %%EOF
I am Allison Goldstein from the Division for Heart Disease and Stroke Prevention at CDC. Uhlig K, Patel K, Ip S, Kitsios GD, Balk EM. To determine predictors of adherence with SMBP monitoring. AHRQ Projects funded by the Patient-Centered Outcomes Research Trust Fund. Finally, SMBP may be useful in preventing overtreatment in individuals with white coat syndrome, orthostatic BP changes, or hypotensive episodes from medication. In: Comparative Effectiveness Review Summary Guides for Clinicians [Internet]. Page originally created December 2020. SMBP = self-measured BP; KQ = Key Question. Content last reviewed March 2021. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness. In addition, SMBP may carry the risk of unreliable BP readings if not obtained in a standard fashion, inappropriate self adjustments of antihypertensive medications, as well as increased anxiety in susceptible patients. First, a health care professional wraps an inflatable cuff around your arm. For SMBP alone versus usual care, the strength of evidence is moderate and supports a lower BP with SMBP (SBP/DBP -3.1/-2.0 mmHg at 6 months). Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. Centers for Disease Control and Prevention. Your feet should be flat on the floor and your legs . The https:// ensures that you are connecting to the Self-measured blood pressure (SMBP) has been used in the treatment of hypertension with three major aims: 1) to avoid undertreatment of hypertension 2) to enhance self-participation in disease management and to enhance adherence; and 3) to avoid overtreatment in those with lower BP out of the clinic compared with in the clinic26, SMBP is being used to avoid undertreatment of hypertension. y ^]J[_tFe^~4:;:Cxbh jXd%SElY*Oi1h{_DsnL The current report evaluates ambulatory BP monitoring only as an outcome measurement tool, not as an intervention of interest. This site provides a list of clinically validated blood pressure devices, based on the American Medical Associations (AMA) established criteria to independently validate clinical accuracy. 45. 45. Rockville (MD): Agency for Healthcare Research and Quality (US); 2007. Rockville, MD 20857 Uhlig K, Patel K, Ip S, Kitsios GD, Balk EM. This is an official U.S. government web site managed by the
Randomized-controlled trials have shown that self-measured blood pressure predicts cardiovascular morbidity and mortality better than office BP measurements. Lipid Screening in Childhood for Detection of Multifactorial Dyslipidemia: A Systematic Evidence Review for the U.S. Preventive Services Task Force [Internet]. Bookshelf All material on this website is protected by copyright, Copyright 1994-2023 by WebMD LLC. Ann Intern Med. >gL/?eEAV
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D G&pA32^Y|VLEcx 71HbFFhi3"9#+Z~GqESHm,Y-G1. Possible comparisons between SMBP, SMBP plus additional support, support without SMBP, and usual care. If you have high blood pressure, talk to your health care team about steps to take to control your blood pressureto lower your risk for heart disease and stroke. Self-Measured Blood Pressure Monitoring: Comparative Effectiveness. There are two BP monitoring strategies that can currently be used at home: Ambulatory and SMBP monitoring. We standardized extraction by training on multiple articles, after which each study was extracted by one methodologist and the extraction reviewed by at least one other. Clinic measurements may not reflect the usual BP outside of the clinic setting throughout a day. Self-blood pressure monitoring, by itself, has been shown to be an effective tool in predominantly white populations, but less studied in minority, urban communities. There is growing evidence that selfmonitoring of blood pressure (SMBP) with guided support beyond usual primary care improves BP control. SMBP with or without additional support may confer a small benefit in BP control compared with usual care, but the BP effect beyond 12 months and the attendant long-term clinical consequences remain unclear. Untreated or ineffectively treated hypertension leads to increased cardiovascular . This feature requires the newest version of Flash. 2012 Feb 15. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. These cookies may also be used for advertising purposes by these third parties. Use this tool to keep track of your blood pressure measurements at home. For example, terminal digit preference (i.e., preference for 0, 5, and even numbers) and single number preference (i.e., preference for specific values such as 130/80 or 140/90 mmHg) can lead to inaccuracies in measurement readings and variability across observers.17,18 This can be prevented when machines provide readings automatically.
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