Technology
Calls to continue home BP monitoring
Professor Melvin Lobo, director of the internationally renowned Barts Blood Pressure Clinic, saw one major positive outcome of the pandemic – people becoming more engaged in their own health, with proactive, self-directed blood pressure (BP) monitoring. He explains why this approach can vastly improve the understanding of patterns in hypertensive patients and, in turn, lead to better patient outcomes.
The COVID-19 pandemic has caused huge changes to the healthcare system. We had to adapt as appointments moved online to minimise face to face contact, meaning patients had to take more responsibility in the management of their health. One area in which this change has been most evident is blood pressure, as people turned to home monitoring with new enthusiasm. The restrictions around in-person consultations meant we could gently encourage even those less engaged in their condition to take regular readings – to help us understand their condition, but also empower them to take charge of their own health and hypertension. This was supported by the launch of the NHS
blood pressure @home initiative which has seen over 220,000 blood pressure monitors handed out to those diagnosed with uncontrolled high blood pressure, as well as tips and advice on how to measure blood pressure at home, and ways to share this information with their GP.1
shift towards home monitoring is a real positive to come from the pandemic and I’d urge other healthcare professionals to encourage the continuation of this.
The scale of the problem Hypertension affects approximately 1.28 billion adults worldwide2
and is a leading cause of
premature death. At present, many individuals do not monitor their blood pressure regularly or suffer from ‘White Coat Hypertension’ where readings are elevated in a doctor’s consulting room or ‘masked hypertension’ where blood pressure appears lower when a measurement is taken in a medical setting – all of which serve to amplify the importance of home blood pressure measurement. Furthermore, a huge number of people do not realise they have hypertension. It is vital that people with diagnosed
hypertension conduct regular readings so they can flag any significant changes to their
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care provider. Increased blood pressure levels indicate a higher risk of potentially fatal stroke or heart attack and monitoring at home is simple to do and can prevent devastating consequences. We often see patients in clinic who rely wholly on their short consultation, then forget about their condition as soon as they leave the consulting room. Of course, we as GPs, practice nurses and specialist consultants have a key role in their care and treatment. But patients are living with their bodies 24/7 and so have the ability to recognise changes and patterns that we cannot. Documenting this via regular blood pressure readings, and then bringing this data to us in the consulting room is invaluable. The events of the pandemic meant that, for the last two years, people have been more attuned to their own health and mortality. This coupled with the practical need for them to monitor their blood pressure at home and report that back, as we simply couldn’t have them in the clinic, meant we started to see far greater take up of home monitoring – in turn,
greatly helping us to identify patient’s blood pressure patterns.
Knowledge breeds confidence Home monitoring has itself changed patients’ attitudes towards their own health – the more they know, the more they want to know about their condition and how to improve it. This is so encouraging to see. Patients seem more empowered than ever, and I hope that the number of people engaged in home blood pressure recording steadily continues to rise. There are plenty of ways to measure blood
pressure at home, most commonly via a cuff. The NHS Blood pressure@home scheme has proven that having monitors in the homes of patients that need them is a really important step in people feeling empowered and engaged with their blood pressure health, enabling them to better understand their condition. GPs and specialists countrywide are being provided with more data than ever to deliver top-quality, informed healthcare based upon up-to-date longitudinal data.
February 2023 I
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