Should Patients Be Self-Titrating Antihypertensive Medications?
(HealthDay News) — Self-monitoring with self-titration of antihypertensive medications is associated with lower blood pressure for patients with hypertension at risk for cardiovascular disease, according to a study published in the August 27 issue of the Journal of the American Medical Association.
Richard J. McManus, PhD, from the University of Oxford in the United Kingdom, and colleagues examined the effect of self-monitoring with self-titration of antihypertensive medication vs. usual care among patients with hypertension and cardiovascular disease, diabetes, or chronic kidney disease. Data were included for 450 patients, aged at least 35 years, with baseline blood pressure of at least 130/80mmHg treated at 59 practices. Patients were randomized to self-monitoring of blood pressure combined with an individualized self-titration algorithm or usual care.
The researchers found that the baseline blood pressure was 143.1/80.5 and 143.6/79.5mmHg in the intervention and control groups, respectively. The mean blood pressure decreased after 12 months to 128.2/73.8 and 137.8/76.3mmHg, respectively, a difference of 9.2 and 3.4mmHg in systolic and diastolic blood pressures, respectively, after adjustment for baseline blood pressure. Results were similar after multiple imputation for missing values. Comparable results were obtained in all subgroups, without excessive adverse events.
"Among patients with hypertension at high risk of cardiovascular disease, self-monitoring with self-titration of antihypertensive medication compared with usual care resulted in lower systolic blood pressure at 12 months," the authors write.
Several authors disclosed financial ties to the medical device and health care industries.