HOPE Asia Network consensus recommendations on home blood pressure monitoring
“One of the key targets [of the WHO] is improving the treatment of hypertension, because it is the most important risk factor for CVD,” commented Professor Sungha Park, lead author of the HOPE Asia Network’s consensus recommendations on home blood pressure monitoring (HBPM). These recommendations provide clear guidance to clinicians in the region on how to incorporate HBPM into routine clinical practice, and thus improve hypertension management.
HBPM is increasingly being recognized as an accurate adjunct to clinic blood pressure (BP) measurement for the diagnosis and management of hypertension, and several international guidelines have now incorporated HBPM into their recommendations. In particular, HBPM reduces the risk of patients with masked hypertension or white-coat hypertension being misdiagnosed through clinic assessments alone, and has shown good predictive power for cardiovascular events.
“HBPM is a better predictor of cardiovascular outcome than office BP. When there is a discrepancy of diagnosis between office and home BP, a home BP-based diagnosis should have priority and, when possible, be confirmed by ambulatory blood pressure monitoring. (Class I, Level of Evidence B)”.
Despite the growing recognition of the value of HBPM, its uptake in Asia has been limited by barriers, including physician inertia and access to validated HBPM devices. The HOPE Asia Network consensus considers these regional challenges in their recommendations to provide implementable guidance on how HBPM can be utilized in the day-to-day management of hypertension.
Professor Park believes that the HOPE Asia Network recommendations will encourage physicians throughout the region to integrate HBPM into the primary care setting. The active monitoring that accompanies HBPM is also an effective method of improving treatment adherence, which can translate into further incremental improvements in BP control.
“HBPM can improve adherence when combined with active intervention, and thus improve BP control compared with current standard care alone (Class I, Level of Evidence B).”
Greater uptake of HBPM is expected to help the Asia-Pacific region meet the WHO’s CVD targets by improving BP management practices and reducing the number of cardiovascular events. Increased uptake of HBPM will also assist the HOPE Asia Network’s efforts to better understand BP control and the prevalence of masked, white-coat and morning hypertension in the region. This enhanced understanding can then be used as a springboard towards further studies of CVD, to better elucidate the characteristics of Asian hypertension patients and the benefits of HBPM.
Reference: Park S, et al. J Hum Hypertens 2018 Jan 31 [Epub ahead of print]