HOME BLOOD PRESSURE MONITORING IN PATIENTS WITH UNCONTROLLED HYPERTENSION: RANDOMIZED CLINICAL TRIAL

Objective: To evaluate the impact of Home Blood Pressure Monitoring (HBPM) on blood pressure (BP) values in hypertensive individuals undergoing drug treatment with uncontrolled BP.Design and method: Randomized controlled clinical trial with individuals diagnosed with hypertension and uncontrolled BP (> 140/90 mmHg), followed from December 2022 to September 2023, in a primary health care unit. Data collection occurred in 5 stages: 1) recruitment; 2) inclusion in the study and collection of baseline data, including information on sociodemographic issues; 3) randomization; and 4) intervention. Participants were divided into two groups: intervention (IG), who received a loan of an automatic BP monitor to take measurements at home, for 5 consecutive days each month; and control (CG), who did not perform HBPM. In these follow-up consultations, for both groups, the researchers performed new BP measurements, using the oscillometric method. The main outcome was the reduction in mean systolic (SBP) and diastolic (DBP) BP values, comparing baseline and post-intervention. The study was approved by a research ethics committee. Results: Seventy participants were randomized, and 43 completed the study. There was a predominance of males, with incomplete elementary education and a mean age of 60.98 (±9.97) years. At baseline, there was no significant difference between the groups for SBP (155 vs. 152 mmHg; P=0.208) and DBP (87 vs. 88 mmHg; P=0.882). At the first follow-up visit, the IG presented lower SBP (140 vs. 150 mmHg;P=0.046) and DBP (78 vs. 83 mmHg; P=0.005) values. At the third and final follow-up visit, the difference persisted, with SBP of 136 vs. 144 mmHg and DBP of 74 vs. 78 mmHg (P=0.001). Conclusions: HBPM resulted in a significant reduction in BP in individuals with uncontrolled hypertension undergoing drug treatment. Therefore, it can be used to achieve and maintain blood pressure goals in primary care.