SELF-MEASUREMENT OF BLOOD-PRESSURE - RECOMMENDATIONS OF THE CANADIAN COALITION FOR HIGH BLOOD-PRESSURE PREVENTION AND CONTROL

OBJECTIVE: To provide health care professionals with guidelines on the use of blood pressure self-measurement. METHODS: Recommendations were devised after consideration of expert reviews and guidelines, persona l files, international standards documents, personal communication wit h investigators and the results of a MEDLINE search (1966-94) using th e term 'blood pressure determination'. BENEFITS, HARMS, COSTS: Self-me asurement of blood pressure can be used to detect white coat hypertens ion, monitor changes in blood pressure closely, more rapidly achieve d esired blood pressure goals, increase adherence to antihypertensive th erapy and improve patient self-reliance. However, self-measured blood pressure readings may be misleading because there is insufficient norm ative, prognostic and outcome data and because some patiients may not take accurate measurements. The use of self-measurement of blood press ure has a relatively small direct cost and may result in an overall re duction in treatment costs. RECOMMENDATIONS: Self-measured blood press ure readings can be a valuable supplement to clinic (or office) blood pressure readings. However, self-measurement is appropriate neither fo r patients who are physically or mentally incapable of accurate assess ment and interpretation of readings nor for those who do not want to p articipate. Patients who self-monitor blood pressure require careful t raining in blood pressure measurement and instruction on the recording and interpretation of blood pressure readings. Advice to patients usi ng monitoring equipment must take into account the needs and abilities of the patient. Although only a few electronic devices for the self-m easurement of blood pressure have met recommended performance standard s, their use may be more appropriate for some patients and the trainin g requirements fewer than if manual devices are used. VALIDATION: The guidelines of several expert groups were examined in the preparation o f these recommendations. The recommendations were presented at the Wor ld Conference on Hypertension Control in 1995 and were reviewed by the parent societies of the Canadian Coalition for High Blood Pressure Pr evention and Control.