In high-risk patients, Self-management program helps reduce blood pressure

Oct 4, 2016 | | Say something

A program that consisted of patients that measures your blood pressure and adjust their antihypertensive medication as a result of lower systolic blood pressure at 12 months compared with patients receiving usual care in a group of patients with hypertension at high risk of cardiovascular disease, a new study has revealed.


 In High-Risk Patients, Self-Management Program Helps Reduce Blood Pressure In high-risk patients, Self-management program helps reduce blood pressure

The study appears in the Aug. 27 edition JAMA .


Data from national and international surveys suggest that despite improvements in the last decade, a significant proportion of patients have poorly controlled high blood pressure. Self-monitoring of blood pressure with self-valuation (adjusting) the results of antihypertensive drugs on blood pressure in patients with hypertension, but no data on patients in high-risk groups, according to background information in the article .

Richard J. McManus, FRCGP, University of Oxford, and colleagues randomized 552 patients with hypertension and a history of stroke, coronary heart disease, diabetes or chronic kidney disease to self-monitoring of blood pressure combined with a car individualized titration algorithm or a control group (patients received usual care consisting of seeing your physician health care for blood pressure measurement and adjustment routine medication if necessary).

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After 12 months, the mean systolic blood pressure decreased in both groups, but was lower in the intervention group (128.2 / 73.8 mmHg vs 137.8 / 76.3 mmHg). The imputation of missing values ​​showed a marginally lower average difference in systolic blood pressure of 8.8 mm Hg. The reduction in diastolic blood pressure was also higher in the group of self-monitoring. The results were comparable in all subgroups, without excessive adverse effects.

“This trial has demonstrated for the first time, to our knowledge, that a group of high-risk individuals with hypertension and significant cardiovascular comorbidity, are able to self-monitor and self-titrate antihypertensive treatment after a pre? Algorithm specified developed with your family doctor and, in doing so, they achieved a clinically significant reduction in systolic and diastolic blood pressure without an increase in adverse events, “the authors write. “This is a population that have more to gain in terms of reducing future cardiovascular events optimized control blood pressure.” There is also an accompanying editorial, entitled, “self-assessment of antihypertensive therapy in high-risk patients bring him home. ‘

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“Although the trial by McManus et al does not resolve all issues relating to self-assessment based on self-measurement is an important step towards the adaptation of treatment for patients who wish to participate actively in their own control step risk factors, “write Peter M. Nilsson, MD, Ph.D., of the University hospital of Skane, Malmo, Sweden, Fredrik H. Nystrom and MD, Ph.D., of the University of Linkoping, Linkoping, Sweden.

“Future trials studying the effects on cardiovascular events self-worth. With the increased awareness of [this trial] are needed, it may be possible to recruit less restricted patients to incorporate education about self as standard procedure and focus on what scheme for certification of use, or to study the calendar records blood pressure at home. in many countries, antihypertensive drugs are now available as generic drugs at low cost. the time has come for noncostly full use of these drugs and to design optimal individualized patient care. ”

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“Based on these findings, a” bring it home ‘strategy for reducing blood pressure it seems appropriate for patients with hypertension and comorbidities. “

Source: Eurekalert

This article was originally published on medindia.net

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