Latest Evidence Shows Home BP Monitoring Vital for Hypertension Management: HOPE Asia Network
Home blood pressure (BP) monitoring has emerged as a crucial tool for managing hypertension, according to the HOPE Asia Network. In recent years, advancements in digital technology have facilitated the accumulation and analysis of time-series big data related to various factors that influence BP. This includes biological indicators, physical activity, and environmental information. Home BP monitoring, in particular, has gained prominence as a reliable and convenient method for assessing BP levels.
Historically, the measurement of BP relied on the auscultatory method described by Russian army surgeon Nikolai Sergeevich Korotkoff in 1905. However, the development of intra-arterial ambulatory BP monitoring (ABPM) in 1966 introduced the concept of BP variability over a 24-hour period. Subsequently, home BP monitoring (HBPM) devices utilizing the oscillometric method were introduced in the 1980s. These devices calculate systolic and diastolic BP based on pulse waves detected by an intra-cuff pressure sensor. Recent technological advancements have further enhanced the convenience and accuracy of measuring BP outside of medical settings.
Hypertension is a critical risk factor for cardiovascular disease, and managing BP levels is essential for reducing associated risks. Studies have shown that even a 20-mmHg difference in office systolic BP can result in more than a two-fold difference in stroke death rates, as well as death rates from ischemic heart disease and other vascular causes. Furthermore, a meta-analysis of randomized clinical trials demonstrated that a mere 5-mmHg decrease in systolic BP can lead to approximately a 10% reduction in the risk of major cardiovascular events.
It is important to recognize that office BP measurements provide only a snapshot of BP levels at a specific time and under specific conditions. They do not reflect the overall BP profile and variability. Over the past three decades, mounting evidence has showcased the importance of out-of-office BP metrics, such as home BP and 24-hour ambulatory BP, in assessing cardiovascular disease risks. As a result, current hypertension guidelines recommend the utilization of both office and out-of-office measurements for diagnosing and managing hypertension.
Recent digital technology innovations have enabled the seamless accumulation, linking, and analysis of time-series big data concerning various factors that influence BP. These advancements offer an opportunity to monitor BP more conveniently and accurately. Among these factors, BP itself, particularly home BP, remains one of the most crucial indicators in both healthcare and medical care.
The HOPE Asia Network, consisting of experts in the field, has emphasized the significance of BP management through home BP monitoring. They have developed consensus statements promoting a practical, personalized health record (PHR)-based approach that centers around home BP. This approach aims to achieve personalized anticipation medicine, which involves predicting the time and place of cardiovascular events based on time-series big data in digital health and medicine.
In conclusion, the latest evidence highlights the importance of home BP monitoring in managing hypertension. The utilization of home BP measurements has proven to be reliable, convenient, and associated with better cardiovascular outcomes. As digital technology continues to advance, the integration of time-series big data and home BP monitoring offers tremendous potential for personalized healthcare. By adopting a home BP-centered approach, healthcare providers can deliver more effective treatments and interventions for hypertension management.
