Published 29 June 2009, doi:10.1136/bmj.b2623
Cite this as: BMJ 2009;338:b2623

Letters

Blood pressure in primary care

Home monitoring, a way to go?

The first 150 words of the full text of this article appear below.

Law and colleagues recommend antihypertensive drugs be prescribed according to risk rather than blood pressure readings.¹ Keenan and colleagues report a lack of benefit from frequent blood pressure monitoring.² The accompanying editorial concludes that the place of the sphygmomanometer in the doctor’s office no longer seems secure.³ Let us hope so.

In 2006 we analysed the concordance between three consecutive measurements of blood pressure in the clinic and the record from ambulatory blood pressure monitoring in a primary care setting.⁴ The positive predictive value of a clinic based diagnosis of hypertension for true hypertension diagnosed by ambulatory monitoring was 71%, and the indication for treatment based on the three consecutive readings (average >160/100 mm Hg) was contradicted by ambulatory monitoring in 75% of cases. This supports the finding that outcomes are largely independent of clinic blood pressure measurements.

Home monitoring empowers patients and seems to provide a picture well correlated . . . [Full text of this article]

¹ LiberCare, PO Box 9729, Newark NG24 9GW

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