Self-monitoring of Blood Pressure in Patients With Hypertension-Related Multi-morbidity: Systematic Review and Individual Patient Data Meta-analysis
© The Author(s) 2019. Published by Oxford University Press on behalf of American Journal of Hypertension, Ltd. BACKGROUND: Studies have shown that self-monitoring of blood pressure (BP) is effective when combined with co-interventions, but its efficacy varies in the presence of some co-morbidities....
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th-mahidol.537242020-03-26T11:51:26Z Self-monitoring of Blood Pressure in Patients With Hypertension-Related Multi-morbidity: Systematic Review and Individual Patient Data Meta-analysis J. P. Sheppard K. L. Tucker W. J. Davison R. Stevens W. Aekplakorn H. B. Bosworth A. Bove K. Earle M. Godwin B. B. Green P. Hebert C. Heneghan N. Hill F. D.R. Hobbs I. Kantola S. M. Kerry A. Leiva D. J. Magid J. Mant K. L. Margolis B. McKinstry M. A. McLaughlin K. McNamara S. Omboni O. Ogedegbe G. Parati J. Varis W. J. Verberk B. J. Wakefield R. J. McManus Cardiovascular Research Institute Maastricht University of Cambridge University of Edinburgh University of Oxford Turun Yliopistollinen Keskussairaala NYU Grossman School of Medicine Queen Mary, University of London Monash University Memorial University of Newfoundland Deakin University Kaiser Permanente Faculty of Medicine, Ramathibodi Hospital, Mahidol University University of Washington, Seattle VA Medical Center Lewis Katz School of Medicine HealthPartners Icahn School of Medicine at Mount Sinai University of Milano - Bicocca University of East Anglia, Faculty of Medicine and Health Sciences St George's Hospital, London University of Colorado at Denver Sechenov First Moscow State Medical University Duke University IRCCS Istituto Auxologico Italiano Primary Care Research Unit of Mallorca Italian Institute of Telemedicine Medicine © The Author(s) 2019. Published by Oxford University Press on behalf of American Journal of Hypertension, Ltd. BACKGROUND: Studies have shown that self-monitoring of blood pressure (BP) is effective when combined with co-interventions, but its efficacy varies in the presence of some co-morbidities. This study examined whether self-monitoring can reduce clinic BP in patients with hypertension-related co-morbidity. METHODS: A systematic review was conducted of articles published in Medline, Embase, and the Cochrane Library up to January 2018. Randomized controlled trials of self-monitoring of BP were selected and individual patient data (IPD) were requested. Contributing studies were prospectively categorized by whether they examined a low/high-intensity co-intervention. Change in BP and likelihood of uncontrolled BP at 12 months were examined according to number and type of hypertension-related co-morbidity in a one-stage IPD meta-analysis. RESULTS: A total of 22 trials were eligible, 16 of which were able to provide IPD for the primary outcome, including 6,522 (89%) participants with follow-up data. Self-monitoring was associated with reduced clinic systolic BP compared to usual care at 12-month follow-up, regardless of the number of hypertension-related co-morbidities (-3.12 mm Hg, [95% confidence intervals -4.78, -1.46 mm Hg]; P value for interaction with number of morbidities = 0.260). Intense interventions were more effective than low-intensity interventions in patients with obesity (P < 0.001 for all outcomes), and possibly stroke (P < 0.004 for BP control outcome only), but this effect was not observed in patients with coronary heart disease, diabetes, or chronic kidney disease. CONCLUSIONS: Self-monitoring lowers BP regardless of the number of hypertension-related co-morbidities, but may only be effective in conditions such obesity or stroke when combined with high-intensity co-interventions. 2020-03-26T04:51:26Z 2020-03-26T04:51:26Z 2020-03-13 Article American journal of hypertension. Vol.33, No.3 (2020), 243-251 10.1093/ajh/hpz182 19417225 2-s2.0-85081945275 https://repository.li.mahidol.ac.th/handle/123456789/53724 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85081945275&origin=inward |
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Medicine J. P. Sheppard K. L. Tucker W. J. Davison R. Stevens W. Aekplakorn H. B. Bosworth A. Bove K. Earle M. Godwin B. B. Green P. Hebert C. Heneghan N. Hill F. D.R. Hobbs I. Kantola S. M. Kerry A. Leiva D. J. Magid J. Mant K. L. Margolis B. McKinstry M. A. McLaughlin K. McNamara S. Omboni O. Ogedegbe G. Parati J. Varis W. J. Verberk B. J. Wakefield R. J. McManus Self-monitoring of Blood Pressure in Patients With Hypertension-Related Multi-morbidity: Systematic Review and Individual Patient Data Meta-analysis |
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© The Author(s) 2019. Published by Oxford University Press on behalf of American Journal of Hypertension, Ltd. BACKGROUND: Studies have shown that self-monitoring of blood pressure (BP) is effective when combined with co-interventions, but its efficacy varies in the presence of some co-morbidities. This study examined whether self-monitoring can reduce clinic BP in patients with hypertension-related co-morbidity. METHODS: A systematic review was conducted of articles published in Medline, Embase, and the Cochrane Library up to January 2018. Randomized controlled trials of self-monitoring of BP were selected and individual patient data (IPD) were requested. Contributing studies were prospectively categorized by whether they examined a low/high-intensity co-intervention. Change in BP and likelihood of uncontrolled BP at 12 months were examined according to number and type of hypertension-related co-morbidity in a one-stage IPD meta-analysis. RESULTS: A total of 22 trials were eligible, 16 of which were able to provide IPD for the primary outcome, including 6,522 (89%) participants with follow-up data. Self-monitoring was associated with reduced clinic systolic BP compared to usual care at 12-month follow-up, regardless of the number of hypertension-related co-morbidities (-3.12 mm Hg, [95% confidence intervals -4.78, -1.46 mm Hg]; P value for interaction with number of morbidities = 0.260). Intense interventions were more effective than low-intensity interventions in patients with obesity (P < 0.001 for all outcomes), and possibly stroke (P < 0.004 for BP control outcome only), but this effect was not observed in patients with coronary heart disease, diabetes, or chronic kidney disease. CONCLUSIONS: Self-monitoring lowers BP regardless of the number of hypertension-related co-morbidities, but may only be effective in conditions such obesity or stroke when combined with high-intensity co-interventions. |
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Cardiovascular Research Institute Maastricht |
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Cardiovascular Research Institute Maastricht J. P. Sheppard K. L. Tucker W. J. Davison R. Stevens W. Aekplakorn H. B. Bosworth A. Bove K. Earle M. Godwin B. B. Green P. Hebert C. Heneghan N. Hill F. D.R. Hobbs I. Kantola S. M. Kerry A. Leiva D. J. Magid J. Mant K. L. Margolis B. McKinstry M. A. McLaughlin K. McNamara S. Omboni O. Ogedegbe G. Parati J. Varis W. J. Verberk B. J. Wakefield R. J. McManus |
format |
Article |
author |
J. P. Sheppard K. L. Tucker W. J. Davison R. Stevens W. Aekplakorn H. B. Bosworth A. Bove K. Earle M. Godwin B. B. Green P. Hebert C. Heneghan N. Hill F. D.R. Hobbs I. Kantola S. M. Kerry A. Leiva D. J. Magid J. Mant K. L. Margolis B. McKinstry M. A. McLaughlin K. McNamara S. Omboni O. Ogedegbe G. Parati J. Varis W. J. Verberk B. J. Wakefield R. J. McManus |
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J. P. Sheppard |
title |
Self-monitoring of Blood Pressure in Patients With Hypertension-Related Multi-morbidity: Systematic Review and Individual Patient Data Meta-analysis |
title_short |
Self-monitoring of Blood Pressure in Patients With Hypertension-Related Multi-morbidity: Systematic Review and Individual Patient Data Meta-analysis |
title_full |
Self-monitoring of Blood Pressure in Patients With Hypertension-Related Multi-morbidity: Systematic Review and Individual Patient Data Meta-analysis |
title_fullStr |
Self-monitoring of Blood Pressure in Patients With Hypertension-Related Multi-morbidity: Systematic Review and Individual Patient Data Meta-analysis |
title_full_unstemmed |
Self-monitoring of Blood Pressure in Patients With Hypertension-Related Multi-morbidity: Systematic Review and Individual Patient Data Meta-analysis |
title_sort |
self-monitoring of blood pressure in patients with hypertension-related multi-morbidity: systematic review and individual patient data meta-analysis |
publishDate |
2020 |
url |
https://repository.li.mahidol.ac.th/handle/123456789/53724 |
_version_ |
1763495163897839616 |