When the best treatment for hypertension is to wait

February 18, 2020

A new study from the University of Missouri concluded that a physician's decision not to intensify hypertension treatment is often a contextually appropriate choice. In two-thirds of cases where physicians did not change treatment for patients with hypertension, patients' blood pressure returned to normal in follow-up readings taken at home. This pre- and post-study tracked 90 patients with hypertension to understand the role that follow-up home blood pressure measures could play in understanding cases of "therapeutic inertia." Sixty-six percent of patients who had a blood pressure reading of 140/90 or higher when they were in the clinic and whose doctors did not change their treatment, had average readings under 140/90 when patients took their blood pressure at home.

According to the authors, there are implications for health care quality metrics. Doctors' success rates in controlling hypertension are based solely on clinic blood pressure rates. The authors extrapolated the home blood pressure metrics to show that when home metrics replaced clinical ones, the department's hypertension control success rates rose from 58% to 86%. They conclude, "Most validated home blood pressure should be accepted and preferred for physician hypertension performance measures."

Additionally, when surveyed after the home blood pressure reading intervention, participants shared that home blood pressure monitoring enhanced their understanding of blood pressure control. Eighty-three percent of participants agreed that they would consider buying a home blood pressure monitor if it was covered by insurance.
-end-
Home Blood Pressure Monitoring in Cases of Clinical Uncertainty to Differentiate Appropriate Inaction From Therapeutic Inertia
Sonal J. Patil, MD, MSPH, et al
http://www.annfammed.org/content/18/1/50

American Academy of Family Physicians

Related Blood Pressure Articles from Brightsurf:

Children who take steroids at increased risk for diabetes, high blood pressure, blood clots
Children who take oral steroids to treat asthma or autoimmune diseases have an increased risk of diabetes, high blood pressure, and blood clots, according to Rutgers researchers.

High blood pressure treatment linked to less risk for drop in blood pressure upon standing
Treatment to lower blood pressure did not increase and may decrease the risk of extreme drops in blood pressure upon standing from a sitting position.

Changes in blood pressure control over 2 decades among US adults with high blood pressure
National survey data were used to examine how blood pressure control changed overall among U.S. adults with high blood pressure between 1999-2000 and 2017-2018 and by age, race, insurance type and access to health care.

Transient increase in blood pressure promotes some blood vessel growth
Blood vessels are the body's transportation system, carrying oxygen and nutrients to cells and whisking away waste.

Effect of reducing blood pressure medications on blood pressure control in older adults
Whether the amount of blood pressure medications taken by older adults could be reduced safely and without a significant change in short-term blood pressure control was the objective of this randomized clinical trial that included 534 adults 80 and older.

Brain blood flow sensor discovery could aid treatments for high blood pressure & dementia
A study led by researchers at UCL has discovered the mechanism that allows the brain to monitor its own blood supply, a finding in rats which may help to find new treatments for human conditions including hypertension (high blood pressure) and dementia.

Here's something that will raise your blood pressure
The apelin receptor (APJ) has been presumed to play an important role in the contraction of blood vessels involved in blood pressure regulation.

New strategy for treating high blood pressure
The key to treating blood pressure might lie in people who are 'resistant' to developing high blood pressure even when they eat high salt diets, shows new research published today in Experimental Physiology.

Arm cuff blood pressure measurements may fall short for predicting heart disease risk in some people with resistant high blood pressure
A measurement of central blood pressure in people with difficult-to-treat high blood pressure could help reduce risk of heart disease better than traditional arm cuff readings for some patients, according to preliminary research presented at the American Heart Association's Hypertension 2019 Scientific Sessions.

Heating pads may lower blood pressure in people with high blood pressure when lying down
In people with supine hypertension due to autonomic failure, a condition that increases blood pressure when lying down, overnight heat therapy significantly decreased systolic blood pressure compared to a placebo.

Read More: Blood Pressure News and Blood Pressure Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.