Home Blood Pressure Monitoring and Hypertension Status Among US Adults: The National Health and Nutrition Examination Survey (NHANES), 2009-2010
ABSTRACT BACKGROUND: Currently, no national prevalence is available on home blood pressure monitoring (HBPM). METHODS: This report is based on national-level, cross-sectional data for noninstitutionalized US adults aged ≥18 years (n = 6,001 participants) from the National Health and Nutrition Examination Survey (NHANES), 2009-2010. RESULTS: Overall, 21.7% of the population reported HBPM in the past year. Using 2010 Census data as a reference, approximately 33 million (14.5%) individuals engaged in monthly or more frequent HBPM. The frequency of HBPM increased with higher age, higher body mass index, higher family income-to-poverty ratio, and a higher number of health-care visits (all, P < 0.05). Adults with health-care coverage engaged in monthly or more frequent HBPM than adults without coverage (16.1% vs. 8.4%; P < 0.05). Among people with hypertension (blood pressure ≥140/90mm Hg or currently taking medication), 36.6% engaged in monthly or more frequent HBPM. Of those with hypertension whom were aware, treated, and controlled, 41.9%, 43.5%, and 42.1%, respectively, engaged in monthly or more frequent HBPM. Adjusting for covariables, those who were aware of, treated for, and controlled their hypertension were more likely to have a higher frequency of HBPM than the reference: unaware, untreated, and uncontrolled (odds ratio (OR) = 3.59; OR = 3.96; and OR = 1.50, respectively). CONCLUSIONS: Approximately 14.5% of adults engaged in monthly or more frequent HBPM. Being aware of hypertension, being pharmacologically treated, and being controlled were associated with an increased frequency of HBPM. Even among these categories of people with hypertension, <50% were using HBPM.
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ABSTRACT: The Eighth Joint National Committee guideline on the management of adult hypertension was recently released. Rather than recommending specific lifestyle modifications as in the Seventh Joint National Committee guideline, the Eighth Joint National Committee endorsed the recommendations of the American Heart Association/American College of Cardiology 2013 Lifestyle Work Group. The Lifestyle Work Group report included systematic reviews and meta-analyses of randomized controlled trials or controlled clinical trials from 2001 through 2011 of " fair to good " quality. In total, 11 reviews qualified for inclusion in the report, 6 of which included blood pressure (BP) as the primary outcome. Three reviews did not find significant reductions in BP, and BP status was not reported in 5. When BP was reported, only 22% of the patients had hyper-tension. Yet, the group concluded with a strength of evidence categorized as " high " that aerobic exercise training reduces BP by 1 to 5 mm Hg in individuals with hypertension and that the most effective exercise interventions on average included aerobic physical activity of moderate to vigorous intensity for at least 12 weeks, 3 to 4 sessions per week lasting 40 minutes per session. The exercise prescription recommendations of the Lifestyle Work Group deviate from those of other professional organizations and committees including the Seventh Joint National Committee, Program. The purposes of this review are to present the existing exercise recommendations for hypertension, discuss reasons for differences in these recommendations, discuss gaps in the literature, and address critical future research needs regarding exercise prescription for hypertension. ª 2015 Mayo Foundation for Medical Education and Research. Mayo Clin Proc. 2015;90(6):801-812Mayo Clinic Proceedings 01/2015; 90(6):801-812. DOI:10.1016/j.mayocp.2015.04.008 · 5.81 Impact Factor
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ABSTRACT: Several evidences have supported the benefits of home blood pressure monitoring (HBPM) in improving hypertension awareness and control. However, little was known about the use of HBPM by hypertensive patients in primary care in China. A cross-sectional questionnaire survey on HBPM use was conducted on 1915 hypertensive patients in Xinzhuang County Hospital in Shanghai, and the factors related to regular use of HBPM were also determined. Overall, 1011 of the 1915 participants engaged in using HBPM, among whom 786 individuals used HBPM more than once a month. Of the 1011 HBPM users, 25.42% chose a mercury sphygmomanometer, 33.55% used wrist-cuff electronic devices, and 46.5% selected arm-cuff electronic devices. In addition, 73% of HBPM users reported HBP readings to their general practitioners. Compared with the less frequent users, patients who used HBPM daily were likely to report their blood pressure (BP) values to the doctors depending on notebook or mechanical memory than on their own memories (P<0.001). Moreover, patients with college education were 2.7 times more likely than those with middle school education or less to engage in frequent HBPM use (odds ratio=2.71, 95% confidence interval=2.03-3.61). This local community survey showed that ∼40% of hypertension patients used HBPM frequently in primary care in China. However, certain patients chose the improper BP monitoring device or questionable reporting methods. Therefore, the use of arm-cuff electric devices with multiple memory storage or a home BP telemonitoring system should be promoted by health education targeted at hypertensive patients.Blood pressure monitoring 06/2014; 19(3):140-4. DOI:10.1097/MBP.0000000000000035 · 1.18 Impact Factor
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ABSTRACT: Background Home blood pressure monitoring (HBPM) is recommended for hypertensive patients as a tool to improve both blood pressure (BP) control and compliance with treatment. Methods We evaluated the use of HBPM in hypertensive subjects examined during a cross-sectional general population survey (Czech post-MONICA). Models predicting the availability and use of HBPM were constructed using univariate and multivariate logistic regression. Results Of 449 treated hypertensive patients (mean age 63.2 years, 52.1% women), 250 (55.7%) reported that they had a device for BP monitoring available at home. The factors associated with HBPM availability were older age, university education, marital status, longer duration of hypertension and nonsmoking. Of the 250 subjects with HBPM available, 40% used HBPM regularly (at least once a week), and this ratio increased with the number of antihypertensive drugs taken (monotherapy 30%, dual combination 43%, combination of ≥3 drugs 48%; ptrend = 0.028). BP control was similar in those using HBPM regularly and those who used HBPM irregularly or did not use it at all (54.5 vs. 49.7%; p = 0.52). Conclusion HBPM is available to more than a half of treated hypertensive patients from the general population. However, only minority of the patients perform home blood pressure measurement regularly.Cor et vasa 04/2014; DOI:10.1016/j.crvasa.2014.02.011