Patient-led dosing for hypertension improves BP control

Allowing hypertensive patients to monitor and adjust drug doses under a programme devised by their GP can improve BP control in high-risk patients, a study has found.

BP check: patient-led monitoring and dose adjustment could cut heart risks (Photo: SPL)
BP check: patient-led monitoring and dose adjustment could cut heart risks (Photo: SPL)

Researchers from the University of Oxford showed that a programme developed by a patient’s GP and tailored to the individual could reduce the risk of future cardiovascular problems.

About one-third of UK patients with hypertension self-monitor their BP, following previous research that showed the benefits of the approach.

But the Oxford study is the first time the effects of self-monitoring and patient-led dose adjustment have been assessed in patients with comorbidities placing them at high risk of cardiovascular events.

A total of 552 patients with hypertension and a significant cardiovascular comorbidity were involved in the study. Comorbidities included cardiovascular disease, diabetes and chronic kidney disease.

Half of the participants were randomly assigned to a ‘usual care’ control group. The rest were instructed to self-monitor their condition and use self-titration to adjust their antihypertensive medication, in a care plan individualised to them by their GP.

After a period of 12 months, patients in the self-monitoring group had lower systolic BP by an average of 9.2mmHg, in comparison with those receiving usual care.

Antihypertensive drug prescriptions also increased by more in the intervention group, particularly in the number of calcium-channel blockers and thiazides prescribed.

Despite this, there was no difference in the number of adverse symptoms reported by either group.

The research team, led by Oxfordshire GP Professor Richard McManus, said: ‘This study has shown self-monitoring with self-titration is feasible in a high-risk population, without special equipment.

‘Most management of hypertension is undertaken in primary care, so it is appropriate that interventions are delivered in this setting.’

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Follow Us:

Just published

Proportion of NHS GPs trained in EEA stabilises despite Brexit uncertainty

Proportion of NHS GPs trained in EEA stabilises despite Brexit uncertainty

The proportion of NHS GPs trained in the EEA has stabilised after a steady decline...

GPs split on calls to suspend appraisal for duration of pandemic

GPs split on calls to suspend appraisal for duration of pandemic

Senior GPs are divided over calls for appraisal to be halted for the rest of the...

GP fears rising over covert recording of consultations in pandemic

GP fears rising over covert recording of consultations in pandemic

Fears over patients covertly recording consultations have increased among GPs since...

Coronavirus: Key guidance GPs need to know about COVID-19

Coronavirus: Key guidance GPs need to know about COVID-19

GPonline provides an overview of the key guidance relating to coronavirus, including...

Care home vaccination to begin as Scottish minister says Pfizer vaccine packs can be split up

Care home vaccination to begin as Scottish minister says Pfizer vaccine packs can be split up

Vaccination of care home residents against COVID-19 will start on 14 December in...

How will the COVID-19 vaccination programme get underway?

How will the COVID-19 vaccination programme get underway?

Following the MHRA's approval of Pfizer/BioNTech's COVID-19 jab the government has...