Prepared by Anne Leonard MPH,BSN,RN FAHA, Senior Science and Medicine Advisor, Lead
- Hypertension, or high blood pressure, is among the most important risk factors that contribute to the incidence of cardiovascular events and chronic kidney disease.
- The diagnosis and management of hypertension has been primarily based on the measurement of blood pressure (BP) in the office, however BP may differ considerably when measured in the office versus outside of the office setting.
- Self-measured BP (SMBP) monitoring, the measurement of BP by an individual outside of the office at home, is a validated approach for out-of-office BP measurement.
- Several U.S. and international hypertension guidelines, scientific statements, and position papers endorse the use of SMBP monitoring for confirming a hypertension diagnosis and managing treated hypertension.
- SMBP monitoring is associated with a reduction in BP and improved BP control, and the benefits of SMBP monitoring are greatest when given along with co-interventions.
- Best practices of SMBP monitoring include the use of validated devices with appropriately sized cuffs and a standardized protocol for BP measurement and monitoring.
- Evidence indicates that SMBP monitoring is cost-effective when compared with office BP monitoring or usual care in individuals with high office BP.
- Barriers to implementation of SMBP monitoring can be surmounted largely by effective education and integration of patients, providers and healthcare systems.
- The lack of coverage for devices and reimbursement of provider time remains a potential barrier to broad use of SMBP monitoring. Coverage of SMBP monitoring among payers varies substantially, with relatively few private and commercial payers and Medicaid plans providing coverage for SMBP monitoring for hypertension diagnosis and management.
- To encourage implementation of SMBP monitoring, investments should be made in building and supporting infrastructure for SMBP monitoring. This includes improving education and training, building health information technology capacity, incorporating SMBP readings into clinical performance measures, supporting co-interventions, and enhancing reimbursement.
Shimbo D, Artinian NT, Basile JN, Krakoff LR, Margolis KL, Rakotz MK, Wozniak G; on behalf of the American Heart Association and the American Medical Association. Self-measured blood pressure monitoring at home: a joint policy statement from the American Heart Association and American Medical Association [published online ahead of print June 22, 2020]. Circulation. doi: 10.1161/CIR.0000000000000803.