Practical aspect of monitoring hypertension based on self-measured blood pressure at home

Devices for home blood pressure (BP) measurement are produced worldwide at a rate of more than 10 million a year and 30 million such devices have already been distributed in Japan. The clinical significance of home BP measurement is obvious; patients can recognize the effects of antihypertensive treatment. Home BP measurements encourage medication compliance, follow-up clinic visits, and active participation in the medical treatment, thus resulting in improved management of hypertension. Home BP measurements more accurately reflect damage to target organs and the prognosis of cardiovascular diseases. The purpose of home BP measurements is to obtain information on the patient's inherent BP pattern using long-term, repetitive measurement under controlled conditions. Since home BP is measured under controlled condition, values are reproducible, and thus, useful in the diagnosis and treatment of hypertension. Blood pressures measured under standardized condition are indispensable when comparing data among individuals, among groups and among institutes. Working Group of Japanese Society of Hypertension (JSH) established JSH Guidelines for Self-Monitoring of Blood Pressure at Home in 2003. Standardization of the measurement procedure may elevate the position of home BP measurements for the purpose of diagnosing and treating hypertension. As a result, home BP measurements may improve the accuracy of screening for hypertension and assessment of BP control during treatment and encourage drug compliance. Home BP measurements, under such controlled conditions, should have a beneficial effect on the economics of diagnosing and treating hypertension.