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Self monitoring of blood pressure at home

BMJ 2004; 329 doi: (Published 14 October 2004) Cite this as: BMJ 2004;329:870
  1. George Stergiou, assistant professor of medicine,
  2. Thomas Mengden, assistant medical director, head of division,
  3. Paul L Padfield, consultant physician,
  4. Gianfranco Parati, associate professor of medicine,
  5. Eoin O'Brien, professor of cardiovascular pharmacology (
  1. Hypertension Center, Third University Department of Medicine, Sotiria Hospital, 152 Mesogion Avenue, Athens 11527 Greece
  2. Division of Hypertension and Vascular Medicine, Medizinische Poliklinik, University Clinic Bonn, Wilhelmstrasse 35, D-5311 Bonn, Germany
  3. Department of Medical Sciences, Western General Hospital, Edinburgh EH4 2HU
  4. University of Milano-Bicocca, Cardiology II, S. Luca Hospital, via Spagnoletto, 3, 20149-Milan, Italy
  5. ADAPT Centre and Blood Pressure Unit, Beaumont Hospital and Department of Clinical Pharmacology, Royal College of Surgeons in Ireland, Dublin 9, Ireland

    Is an important adjunct to clinic measurements

    Although measurement of blood pressure in the clinic is said to be the cornerstone of decision making in hypertension, such measurements may be unrepresentative of a patient's true blood pressure because of random fluctuations and the white coat effect.14 In addition, doctors rarely measure blood pressure according to recommended standards.4 Aimed at improving hypertension management, the 2003 US Joint National Committee recommends the use of self monitoring of blood pressure before considering the more expensive, but better validated ambulatory monitoring of blood pressure.2 Both the Joint National Committee and the 2003 guidelines from the European Society of Hypertension and the European Society of Cardiology suggest that self monitoring might also be used as an alternative to ambulatory monitoring for the diagnosis of white coat hypertension.1 2 The 2004 British Hypertension Society guidelines also acknowledge the increasing use of self monitoring in clinical practice and provide a threshold level for the diagnosis of hypertension (more than 135/85 mm Hg).3 In addition, two websites ( and provide information on validated devices for self monitoring.

    Cross sectional data and one outcome …

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