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.

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Version: Final published version
License: CC BY-NC-ND 4.0
Serval ID
serval:BIB_BBBF0FB92D1B
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
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.
Journal
Kidney & blood pressure research
Author(s)
Spirk D., Noll S., Burnier M., Rimoldi S., Noll G., Sudano I.
ISSN
1423-0143 (Electronic)
ISSN-L
1420-4096
Publication state
Published
Issued date
2018
Peer-reviewed
Oui
Volume
43
Number
3
Pages
979-986
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
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.
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.
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.
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.
Keywords
Aged, Antihypertensive Agents/therapeutic use, Awareness, Biphenyl Compounds/therapeutic use, Blood Pressure/drug effects, Blood Pressure Monitoring, Ambulatory/methods, Drug Therapy, Combination/methods, Female, Goals, Humans, Hydrochlorothiazide/therapeutic use, Male, Middle Aged, Self Care/standards, Switzerland, Tetrazoles/therapeutic use, Treatment Outcome, Antihypertensive therapy, Arterial hypertension, Goal attainment, Home blood pressure monitoring, Tolerability
Pubmed
Web of science
Open Access
Yes
Create date
29/07/2018 14:07
Last modification date
20/08/2019 16:29
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