Self-Blood Pressure Monitoring in an Urban, Ethnically Diverse Population | Journal Scan

Study Questions:

Does self-monitoring of blood pressure (BP) among minority urban hypertensive patients improve blood pressure control?


This was a randomized controlled trial conducted in community clinics in New York in collaboration with the New York City Health Department. The Health Department started a program to have patients in 19 clinics (eight sites were included in the study), which serve medically underserved neighborhoods, self-monitor their blood pressure (BP). The patients in these clinics were predominately black or Hispanic. Participants were included if they had a diagnosis of hypertension (for 6 months or more) which was uncontrolled (defined as ≥140/90 mm Hg or ≥130/80 mm Hg for those with diabetes mellitus or chronic kidney disease). Participants in the intervention arm were provided with a home BP monitor, and training in the proper use of the monitor to record a resting BP. The control group received usual care. The primary outcome of interest was controlled BP.


A total of 900 participants (450 per arm) were included in the study. The majority of the participants (91% for the intervention group and 93% for the control group) completed a baseline visit and at least one follow-up visit within 10 months. The median number of visits for each participant was five for both study arms. After 9-month follow-up, no difference in BP was noted for the two groups (systolic BP 14.7 mm Hg for the intervention group vs. 14.1 mm Hg for the control group, p = 0.70). Controlled BP was achieved for 38.9% of the intervention group and 39.1% for the control group.


The investigators concluded that self-monitoring of blood pressure did not improve BP control compared to usual care in an urban minority population.


As the authors point out, additional barriers for these participants, including those with limited means and without insurance, provided additional barriers to adequate control beyond self-monitoring. Tailoring interventions to improve BP control will likely include self-monitoring, but will also require additional measures.

Clinical Topics: Diabetes and Cardiometabolic Disease, Prevention, Hypertension

Keywords: Blood Pressure, Blood Pressure Determination, Blood Pressure Monitoring, Ambulatory, Primary Prevention, Control Groups, Follow-Up Studies, Hypertension, Medically Underserved Area, Urban Population, African Americans, Hispanic Americans, Metabolic Syndrome X

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