![]() 12, 13 In both studies, the prescribing physicians were masked to the method of blood pressure measurement and used a common target blood pressure for both home and clinic readings (140/90 mm Hg) as opposed to lower home targets (typically 135/85 mm Hg) as recommended by contemporary guidelines. 10 Many primary-care physicians incorporate self-monitored readings in their treatment decisions, but there is considerable variation in practice, 11 and mixed evidence to support such an approach: two previous European studies with 12 months follow-up where physicians used self-monitored blood pressure to explicitly titrate antihypertensive medication have resulted in worse blood pressure control. 8, 9 Self-monitoring in isolation is not associated with better blood pressure control, but is effective in combination with other co-interventions. Self-monitoring as part of a self-management strategy is an effective way to improve blood pressure control, but is only applicable to those willing to self-titrate. ![]() 3, 4 Key reasons for this include clinical inertia, poor adherence, and organisational failure. ![]() 1, 2 Despite the widespread availability of effective treatment, control of hypertension in the community remains sub-optimal. Hypertension is a leading risk factor for cardiovascular disease, the greatest cause of morbidity and mortality internationally. ![]()
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