Antihypertensive Treatment Based on Blood Pressure Measurement at Home or in the Physician's OfficeA Randomized Controlled Trial

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Abstract
A 1997 study1 reported that adjustment of antihypertensive treatment based on ambulatory monitoring instead of conventional blood pressure (BP) measurement at the physician's office led after 6 months of follow-up to less intensive drug treatment with preservation of BP control, general well-being, and inhibition of left ventricular enlargement but did not reduce the costs of antihypertensive treatment. In comparison with ambulatory monitoring, self-measurement of BP at home is less expensive. If applied in a standardized way, self-measurement accomplishes several of the advantages of ambulatory monitoring, including the greater number of BP measurements, the absence of the white-coat syndrome, and, when automated devices are used, the lack of observer bias.2 Furthermore, self-measurement increases compliance with antihypertensive therapy and, compared with usual management, may lead to fewer clinic visits.3