Most Read Articles
07 Dec 2018
Less focus must be given on pretreatment blood pressure (BP) levels, which rarely predict future untreated BP levels or rule out capacity to benefit from BP lowering in high cardiovascular risk patients, according to recent study. Focus must be directed instead on prompt, empirical treatment to maintain lower BP for individuals with high BP or high risk.

Home blood pressure monitoring in Asia: Where are we now?

21 Dec 2017
Data presented at the 13th Asian-Pacific Congress of Hypertension, and recently published in the Journal of Clinical Hypertension, highlighted the current challenges of hypertension management in Asia and how home blood pressure monitoring (HBPM) may improve cardiovascular outcomes. We discussed the review article with Professor Yook-Chin Chia from the University of Malaya, Malaysia, lead author and a member of the HOPE Asia Network, a group of experts dedicated to improving cardiovascular outcomes in Asia.

The HOPE Asia Network notes that hypertension is one of the more common modifiable risk factors for cardiovascular disease and encourages physicians to engage and involve patients in managing their blood pressure. Nevertheless, despite a high prevalence of hypertension in Asia, awareness appears to be low, with inadequate treatment and poor control. For instance, 31.6% of adults aged >20 years in Hong Kong have hypertension, but awareness and treatment rates amongst the general population are only 46.2% and 69.2%, respectively, contributing to an unsatisfactory control rate of 25.8%.

HK-PFR-578a1 Chia figure

HBPM is a validated and accurate tool that lets patients have an active role in managing their hypertension. In addition, HBPM can assess normotension with increased certainty, and measurements are better correlated with target organ damage and cardiovascular outcomes than with in-clinic measurements. As such, HBPM helps improve the allocation, and consequently, the predicted effects of antihypertensive treatment. Patient involvement can also enhance treatment adherence.

“We know that there are situations where blood pressure is falsely elevated when patients come into our clinics, but by performing multiple blood pressure measurements at home, where patients are less stressed, we gain a more accurate reflection of their true blood pressure.”

The prognostic value of information garnered from HBPM means that it is gaining clinical popularity. However, its uptake in Asia has been slow. The HOPE Asia Network’s efforts highlight significant variance in both the prevalence of hypertension and clinical management strategies across Asia. “There are a multitude of reasons as to why the prevalence is high in some places, including a lack of education and patient awareness, primarily because hypertension is often an asymptomatic condition,” explained Professor Chia. In addition, the varied adoption of HBPM in many countries may be due to differences in healthcare services, availability of guidelines on HBPM, and perhaps an overall lack of urgency.

“Patients utilizing home blood pressure monitoring tend to have greater blood pressure control, are much more adherent and report an improved quality of life.”

In future, the HOPE Asia Network aims to expand their reporting on the utility of HBPM through a cross-sectional study. The Network has already developed an Asia-specific consensus statement on HBPM. Professor Chia concluded that by forming a strategy for consensus across Asia, management of hypertension can be improved, helping patients achieve better outcomes.

Click here to access the full article: Chia Y-C, et al. J Clin Hypertens 2017;19:1192–1201

Click here to view the interview video with the lead author -
Professor Yook-Chin Chia
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Most Read Articles
07 Dec 2018
Less focus must be given on pretreatment blood pressure (BP) levels, which rarely predict future untreated BP levels or rule out capacity to benefit from BP lowering in high cardiovascular risk patients, according to recent study. Focus must be directed instead on prompt, empirical treatment to maintain lower BP for individuals with high BP or high risk.