Effect of Home Blood Pressure Monitoring on Patient's Awareness and Goal Attainment Under Antihypertensive Therapy: The Factors Influencing Results in Anti-HypertenSive Treatment (FIRST) Study.

Spirk, David; Noll, Sarah; Burnier, Michel; Rimoldi, Stefano; Noll, Georg; Sudano, Isabella (2018). Effect of Home Blood Pressure Monitoring on Patient's Awareness and Goal Attainment Under Antihypertensive Therapy: The Factors Influencing Results in Anti-HypertenSive Treatment (FIRST) Study. Kidney & blood pressure research, 43(3), pp. 979-986. Karger 10.1159/000490687

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BACKGROUND/AIMS

Despite availability of a broad spectrum of blood pressure (BP)-lowering drugs many hypertensive patients do not attain BP goals. We aimed to evaluate the influence of home blood pressure monitoring (HBPM) on patient's awareness and attainment of BP goals under antihypertensive treatment with irbesartan alone or in combination with hydro-chlorothiazide.

METHODS

In total, 1,268 patients with arterial hypertension were enrolled in the Factors Influencing Results in anti-hypertenSive Treatment (FIRST) study by 348 general practitioners and internal medicine specialists across Switzerland. Patients selected for HBPM received detailed information and training on BP self-management. The study endpoints included patient's awareness and attainment of BP goals, and the efficacy and tolerability of antihypertensive treatment at 3 months.

RESULTS

Overall, the mean age was 61±13 years and 616 (49%) were women. The mean systolic/diastolic BP was 161±17/96±11 mmHg, and 239 (19%) patients had diabetes mellitus. 758 (60%) patients were instructed to use HBPM. Both the proportion of patients aware of their BP goals (81% vs. 70%; p< 0.001) and the percentage of patients reaching their BP goal (64% vs. 57%; p=0.028) were higher in those with vs. without HBPM. The mean reduction in systolic/diastolic BP was 23.8/13.2 mmHg. Only 35 (3.0%) patients discontinued antihypertensive therapy.

CONCLUSION

In a large Swiss cohort of patients with arterial hypertension, information and training on BP self-measurement and direct involvement of patients by using HBPM led to improvement in BP control. Treatment with irbesartan alone or in combination with hydrochlorothiazide was well tolerated and markedly reduced BP.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Pharmacology

UniBE Contributor:

Spirk, David and Rimoldi, Stefano

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1423-0143

Publisher:

Karger

Language:

English

Submitter:

Celine Joray

Date Deposited:

30 Jan 2019 12:53

Last Modified:

01 Dec 2020 15:20

Publisher DOI:

10.1159/000490687

PubMed ID:

29940594

Uncontrolled Keywords:

Antihypertensive therapy Arterial hypertension Goal attainment Home blood pressure monitoring Tolerability

BORIS DOI:

10.7892/boris.124980

URI:

https://boris.unibe.ch/id/eprint/124980

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