Volume 4 • Issue 4 • 1000183
Fam Med Med Sci Res
ISSN: 2327-4972 FMMSR, an open access journal
Rodríguez et al., Fam Med Med Sci Res 2015, 4:4
DOI: 10.4172/2327-4972.1000183
Research Article Open Access
Does Self-measurement of Blood Pressure (SMBP) Contribute to Improve
the Degree of Hypertension Control?
Ángel Díaz Rodríguez
1
*, Ana Beatriz De Abajo Larriba
2
, Enrique Méndez Rodríguez
3
, Beatriz Peleteiro Cobo
3
, Omar Mahmoud Atoui
4
, Rocío
Alvarez López
4
, Serafín de Abajo Olea
5
, Jessica Capón Álvarez
6
and María Jesús Álvarez López
7
1
Specialist in Family and Community Medicine. Bembibre Health Center. León. Professor of the University of León, National Coordinator of the Working Group Lipid
SEMERGEN. C/ Maestro Alberto Carbajal, 1, 24300. Bembibre, León, Spain
2
Specialist in Anesthesiology and Resuscitation. Department of Anesthesiology and Resuscitation. University Hospital of Leon, C/ Altos de Nava S/N. 24071 León, Spain
3
3nd year internal medical resident of Family and Community Medicine, Bembibre Health Center. C/ Maestro Alberto Carbajal, 1, 24300, Bembibre, León, Spain
4
Specialist in Family and Community Medicine, Bembibre Health Center, C/ Maestro Alberto Carbajal, 1, 24300. Bembibre, León, Spain
5
Specialist in Family and Community Medicine, Health Center of San Andres de Rabanedo, Associate Professor of the University of León, C/ Burbia, 23, 24010 San Andrés
de Rabanedo, León, Spain
6
1st year internal medical resident of Family and Community Medicine, Bembibre Health Center, C/ Maestro Alberto Carbajal, 1, 24300, Bembibre, León,
7
University Diploma in Nursing, Bembibre Health Center, C/ Maestro Alberto Carbajal, 1, 24300, Bembibre, León, Spain
*Corresponding author: Dr. Ángel Díaz Rodríguez, MD, PhD, Bembibre Health
Center, C/ Maestro Alberto Carbajal, 1, 24300, Bembibre. León, Spain, Tel:
+34639891743; E-mail: med015917@yahoo.es
Received June 26, 2015; Accepted August 26, 2015; Published August 30, 2015
Citation: Rodríguez ÁD, De Abajo Larriba AB, Rodríguez EM, Cobo BP, Atoui
OM, et al. (2015) Does Self-measurement of Blood Pressure (SMBP) Contribute
to Improve the Degree of Hypertension Control? Fam Med Med Sci Res 4: 183.
doi:10.4172/2327-4972.1000183
Copyright: © 2015 Rodríguez ÁD, et al. This is an open-access article distributed
under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the
original author and source are credited.
Keywords: Hypertension; Ambulatory blood pressure measurement;
Control; Treatment
Introduction
Cardiovascular disease (CVD) is the leading cause of death
worldwide and also in the whole of Spain [1]. Hypertension is one of
the major cardiovascular risk factors contributing to this mortality.
33% of the Spanish population is hypertensive, reaching 68% at the age
of 60. Out of these, nearly two thirds know that they have the disease.
Among these, 79% are treated with antihypertensive drugs. Finally,
among those treated, 46% have blood pressure controlled. Terefore,
just over 20% of hypertensive Spanish people are adequately controlled
[2].
Te degree of control of hypertensive patients seen in primary care
is insufcient; although it has been observed a progressive increase in
the diferent studies CONTROLPRES from 1995 to 2003, increasing
from 13% to 38.8% [3]. More recently in the PRESCAP study, the
degree of BP control was 36.1% in 2002 [4] and 41.4% in 2006 [5].
Although there have been important advances in the understanding,
treatment and control of hypertension in recent years in Spain [2,6]
the reality is that the level of control and treatment remain improvable.
Te method traditionally used for the diagnosis and management
of hypertension has been the measurement of BP in Primary Care with
mercury or aneroid sphygmomanometers. At the population level this
method has proven BP relationship to cardiovascular morbidity and
mortality.
Moreover, it is known that with the clinical measures to outpatients
the alert reaction of the consult is not avoided, the BP variability is not
reported and mistakes in the measurement process are frequent. Leading
to committing errors in the process of diagnosis and monitoring of
hypertension. It is estimated that 20-30% of the decisions made based
only on clinical measures will be wrong [7].
Te domiciliary measures (SMBP) have shown a good correlation
with ambulatory motorization of blood pressure (AMBP), high
Abstract
Background and objectives: Self-measurement of blood pressure can be associated with a better control of blood
pressure. The objectives of this study were to determine the degree of control with two measuring methods (clinical
blood pressure measure and self-measurement of blood pressure) and determine the factors associated with poor
control.
Methods: Multicenter randomized cross-sectional Study in Hypertensive patients diagnosed and treated at Primary
Care. Recollected data included: socio-demographic profles, personal history, standard blood tests and arterial pressure
measure by self-measurement of blood pressure and clinical blood pressure measure. Control objectives included for
self-measurement of blood pressure (<135/85 mmHg) and for clinical blood pressure measure (<140/90 mmHg). Data
are expressed in percentages and averages with a CI of 95%.
Results: 514 patients where included (59.3% female) with a mean age of 70.84 (80.01-61.67) years old and
10.37 (14.87-5.62) years of hypertensive disease evolution. The degree of control was 84.67% (83.58-85.76) with
self-measurement of blood pressure and 68.54% (67.31-69.77); p<0.0001. Patients controlled by self-measurement
of blood pressure took 2.58 (1.65-3.51) versus 2.97 (2.11-3.83) with clinical blood pressure measure; p<0.001. Being
more frequent the use of fxed combinations. Obesity, diabetes, hyperlipidemia, cardiovascular disease, severity
of hypertension, measurement method, number of drugs and age were associated with poorer control of the blood
pressure; p<0.001.
Conclusions: The degree of control with self-measurement of blood pressure is very high, compared with ambulatory
monitoring, with important clinical signifcance. Although the characteristics of this study can not infer causality, this
fnding reinforces the recommendations of the Clinical Practice Guidelines for the regularly use of the self-measurement
of blood pressure in our daily practice.
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ISSN: 2327-4972
Family Medicine and Medical Science
Research