Home or self blood pressure measurement? What is the correct term?

ABSTRACT

OBJECTIVE: Blood pressure measurements taken by patients at home (HBP) are usually referred to as 'self' or 'home' measurements. To demonstrate the most appropriate term we compared self-home measurements (S-HBP), with home measurements taken by relatives (R-HBP), clinic measurements taken by physicians (P-CBP) and self-measurements in the clinic (S-CBP). PATIENTS AND METHODS: Thirty treated hypertensives were randomized to an initial clinic BP (CBP) monitoring period (week 1, P-CBP followed by S-CBP measurements, or the opposite; 1 visit each), then to a HBP monitoring period (weeks 2-3, S-HBP followed by R-HBP or the opposite; 3 workdays each), and finally to a second CBP monitoring period (week 4, S-CBP followed by P-CBP, or the opposite). Triplicate morning trough measurements were taken per occasion using the same fully automated device. RESULTS: There was no difference between S-CBP and P-CBP (mean difference -1.9 +/- 6.1 mmHg, 95% confidence interval (CI) -4.2, 0.4/-1.6 +/- 4.7, 95% CI -3.3, 0.2, systolic/diastolic), or between S-HBP and R-HBP (-0.9 +/- 6.9, 95% CI -3.5, 1.8/-0.4 +/- 4.3, 95% CI -2.0, 1.2). S-CBP was higher than S-HBP (mean difference 9.3 +/- 9.0/4.9 +/- 5.4 mmHg, systolic/diastolic, P < 0.001) and R-HBP (8.4 +/- 9.1/4.5 +/- 5.0, P < 0.001). P-CBP was also higher than S-HBP (11.2 +/- 11.9/6.5 +/- 6.8, P < 0.001) and R-HBP (10.3 +/- 11.2/6.1 +/- 6.5, P < 0.001). CONCLUSIONS: Self-measurements provide similar BP levels to measurements taken by relatives or physicians, provided that measurements are taken in the same setting. 'Self-BP' is a misnomer because self-measurement has no impact on the difference between home and clinic BP. Given that this difference can be exclusively attributed to the effect of the different setting, the term 'home BP' represents a more appropriate term.