Without guidance, patients often deviate from guidelines and do not perform high-quality measurements.

Out-of-office self-measured blood pressure (BP) monitoring is recommended widely by US guidelines for managing hypertension. International guidelines also suggest standardised monitoring times – i.e. twice daily in the morning and evening, with averaging over seven days – and using proper positioning; however, adherence to these guideline recommendations is inconsistent. In this study, researchers surveyed 350 Australian adults with hypertension to explore how they performed self-measured BP monitoring. Key outcomes were as follows:

• fewer than 40% of patients reported receiving education about performing self-measured BP monitoring; those who did not receive guidance reported mimicking the approach of their healthcare professional or looking online for resources
• most patients followed some recommendations for proper preparation (e.g. seated, arm supported, cuff on bare skin)
• many patients checked BP when they were stressed or in pain and did not avoid prior caffeine or food intake
• very few patients measured their BP twice daily (less than 20%) or averaged their BP readings (less than 30%)
• notably, patients used higher thresholds for ‘high’ readings than guidelines recommend.

Comment: Without proper guidance, patients might check their BP at inconsistent times and with improper positioning, which increases the likelihood of elevated readings. High-quality patient education resources are widely available in many languages (e.g. targetbp.org 7-day recording log, targetbp.org infographic on self-measured BP); I use these resources daily in my clinical practice. Providing patients with clear instructions on correct BP measurement is critical to ensure accuracy and will empower and engage them in their care.

Jennifer L. Cluett, MD, Assistant Professor of Medicine, Harvard Medical School, Boston, USA.

Clapham E, et al. Home blood pressure measurements are not performed according to guidelines and standardized education is urgently needed. Hypertension 2025; 82: 149-159.

This summary is taken from the following Journal Watch titles: General Medicine, Ambulatory Medicine, Cardiology.