The role of home blood pressure measurement in managing hypertension: an evidence-based review

This article reviews the current literature regarding the role of home measurement of blood pressure (BP) in the management of hypertension. Subjects with hypertension can use simple automated devices to measure their own BP at home. The results can be accurate and reliable, and because multiple readings allow a mean value to be calculated, a better estimate of the underlying BP level is obtained. Home measurement of BP gives results which are equivalent to the accepted 'gold standard' measure of ambulatory BP values, whilst using a simpler and much less expensive technique which is therefore more widely available. Both methods are better than conventional office measurements in identifying the 'true' or underlying mean BP level and identifying falsely raised levels or 'white coat hypertension'. White coat hypertension confounds the treatment of hypertension, but may not be entirely harmless. Ambulatory BP is a better predictor of cardiovascular prognosis than clinic BP. The use of home BP measurement as an equivalent, feasible, and (apparently) more cost-effective technique to measure BP in hypertension, should enable groups of patients with a poorer prognosis to be identified and their treatment adjusted in order to improve their prognosis.