A new study finds that patients with hypertension who are given control over monitoring their blood pressure as well as making adjustments to their medications are better able to lower their systolic blood pressure than those who use convention treatment.
Aimed at those with diabetes, chronic kidney disease or other major cardiovascular risk factors, the study from researchers in the United Kingdom found that putting care in patients’ hands – including adjusting medications based on a protocol established between doctors and patients at the start of the study if readings remain high – was more effective than traditional doctor visits, which did not always include adjustments to medications.
“We know that even in the best studies, action is taken only about half the time when a raised blood pressure is recorded,” said Richard J. McManus, Ph.D., of the University of Oxford, who headed the study. “So our idea was to have a plan in place, and give patients more control so they can make a change when blood pressure is above a certain level.”
The study included 552 patients with hypertension 35 years old or above with a history of cardiovascular disease, diabetes, chronic kidney disease or coronary heart disease.
Half of the participants were randomly assigned to make an appointment with their family physician for a blood pressure check, with follow-ups at the discretion of their physician. The other half was trained to monitor their own blood pressure and adjust medications before meeting with their family physicians to outline an individualized plan for managing blood pressure and medications.
After a year, those who managed their own care had lower systolic blood pressure than those who were more reliant on their doctors.
“What makes the study of particular clinical importance is the recruitment of patients who were at high risk of cardiovascular disease and the demonstration that the patient-centered technique was safe with no increase in adverse events compared with traditional treatment in a randomized setting,” wrote Peter M. Nilsson, MD, PhD, of Lund University in Sweden, and Fredrik H. Nystrom, MD, PhD, of Linkoping University in Sweden, in an accompanying editorial.
The study appeared in the Journal of the American Medical Association.