The European Society of Hypertension (ESH), the American Heart Association (AHA) and the American Society of Hypertension (ASH) have published guidelines for self-monitoring of blood pressure (SBPM). McGowan and Padfield wished to demonstrate the equivalence of SBPM with ambulatory blood pressure monitoring (ABPM) in the assessment of hypertension. A total of 87 consecutive subjects referred from primary care for standard ABPM underwent a 1-week period of SBPM, as defined by the ESH guidelines, either before or after ABPM. There was no difference in mean blood pressure (BP): SBPM 142/87 mm Hg, daytime average ABPM 141/86 mm Hg. The intra-class correlation coefficient was 0.72 and 0.89 for systolic and diastolic pressure, respectively. SBPM is concordant with ABPM in classifying subjects as hypertensive or normotensive in 87% of cases (kappa=0.56). The coefficient of variation of SBPM compared with ABPM was 5%. In answer to a direct question 81% of subjects preferred SBPM to ABPM. The current self-monitoring schedule recommended by the ESH, AHA and ASH is valid. The mean BP obtained from SBPM is equivalent to awake-time BP on ABPM, the accepted reference standard for 'out of office' BP measurement.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH ARE PROVIDER: The authors concluded that SBPM is simpler to carry out, preferred by patients, and should be considered on a par with ABPM.

WHAT THE STUDY MAY MEAN TO YOU AS A PATIENT: The study shows that if you have high blood pressure and wish to monitor it, your results are as valid as those obtained in the health care providers’ office. The caveat is that you always do the monitoring according to the instructions you have been provided, using reliable equipment.

N McGowan, PL Padfield. Self blood pressure monitoring: a worthy substitute for ambulatory blood pressure? Journal of Human Hypertension, February 18, 2010.