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Effect of home blood pressure monitoring for blood pressure control in hypertensive patients taking multiple antihypertensive medications including fimasartan (the FORTE study)

机译:家用血压监测对高血压患者血压控制的影响,包括FIMASARTAN(Forte Study)

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Abstract Background Although recent hypertension guidelines recommend home blood pressure (HBP) monitoring, its effect in clinical practice is not well known. This study aimed to identify current HBP measurement status and obstacles and their efficacy on blood pressure (BP) control. Methods Sixty-three intervention and 61 control centers with 2483 (mean age: 58.0?years, 56.0% male) drug-na?ve stage 2 hypertensive patients or patients requiring second anti-hypertensive medications were included. The intervention group was instructed to measure HBP twice a day for 7?days from the scheduled visit at 4, 8, and 12?weeks. Results At the end of 12?weeks, 842 (68.7%) and 807 (64.15%) patients of the control and intervention groups, respectively, achieved a target BP. The odds ratio (OR) for improving BP control of HBP was 0.836 (95% confidence interval [CI]: 0.694–1.007). Among intervention group, clinic BP of the subgroup those measured their HBP at least once well controlled compared to subgroup those not measured their HBP at all (OR 1.602, 95% CI: 1.182–2.172). Only 19.17% ( n =?476) had a home sphygmomanometer, and among those, 26.89% measured their BP at least once a week and 34.87% did not measure the BP at all. The obstacles of HBP measurement were lack of awareness of its importance (40.83%), lack of confidence on how to measure BP and maintain the measurement (37.04%), and difficulty in selecting an appropriate device (14.41%). Conclusions HBP measurement alone did not improve BP control, but better compliance with the HBP measurement resulted in improved BP control. Trial registration ClinicalTrials, NCT03254914 , Registered 21 August 2017.
机译:摘要背景虽然最近的高血压指南推荐家用血压(HBP)监测,但其在临床实践中的效果是不公知的。本研究旨在识别当前的HBP测量状态和障碍及其对血压(BP)控制的功效。方法采用六十三种干预和61个控制中心(平均年龄:58.0岁,56.0%男性)药物-NA'Ve 2阶段2高血压患者或需要第二次抗高血压药物的患者。干预组被指示每天两次衡量HBP,从预定访问4,8和12个星期内每天衡量7天。结果在12次?周末,842周(68.7%)和807(64.15%)的对照和干预组患者达到目标BP。改善HBP的BP对照的差距(或)为0.836(95%置信区间[CI]:0.694-1.007)。在介入组中,与根本未测量其HBP的亚组(或1.602,95%CI:1.182-2.172)相比,亚组的临床BP至少一次测量其HBP至少一次良好控制。只有19.17%(n =?476)有一个家庭血压计,其中26.89%,每周至少一次测量其BP,34.87%根本没有衡量BP。 HBP测量的障碍缺乏对其重要性的认识(40.83%),对如何测量BP的缺乏信心并保持测量(37.04%),并难以选择合适的装置(14.41%)。结论单独的HBP测量并未改善BP控制,但更好地遵守HBP测量导致改善的BP控制。试验登记诊所,NCT03254914,注册2017年8月21日。

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