ASSOCIATION BETWEEN FREQUENT HOME BLOOD PRESSURE MEASUEMENT AND BLOOD PRESSURE CONTROL RATE IN HYPERTENSIVE PATIENTS

초록

Objective: Home blood pressure measurement (HBPM) is recommended for accurate diagnosis and effective management of hypertension. Prior studies have demonstrated that HBPM is more closely associated with target organ damage and cardiovascular outcomes than office BP measurements. However, real-world data on the impact of HBPM on BP control are limited. We investigated whether frequent HBPM would improve BP control rates in real-world settings. Design and method: We collected consecutive HBPM data from 3,116 patients from January 2022 to October 2024 across four centers (three tertiary centers and one primary hospital). Patients who measured their HBPM for less than 3months or fewer than 10 times in total were excluded. Finally, 2,146 patients (age 57 ± 10years, 49% females) were included in this study. Patients were stratified into three groups based on HBPM frequency, and clinical profiles, HBPM results, and BP control rates were compared across groups. Results: Over a median follow-up of 83 [45 – 112] weeks, 94% of patients achieved systolic BP (SBP) of < 135mmHg, 82% achieved <130mmHg, and 32% achieved <120mmHg. The group with the most frequent HBPM was older and more likely to be from tertiary hospitals. This group also had lower mean SBP and diastolic BP (DBP), and greater SBP and DBP difference than other groups (Table 1). Regarding BP control rate, there was no difference among groups when the target SBP was set as <135mmHg or <130mmHg, whereas the group with the most frequent HBPM had a higher rate of achieving SBP <120mmHg (p=0.014). This pattern was consistent across subgroups stratified by age, except the patients aged over 70years. Male patients had a lower SBP control rate than females (p<0.001). However, in males, those in the highest HBPM frequency were more likely to achieve SBP <120mmHg (p=0.001), a difference not observed in female patients. Conclusions: Patients who measured their home BP more frequently had a higher strict BP control rate, suggesting that enhanced patient engagement through HBPM may improve strict BP control rate.