A Study in the Use of Home Blood Pressure Monitoring and Telephone Follow-up to Control Blood Pressure

A Structured Program for Hypertension Control in Community Clinics: A Randomized Trial

The purpose of this study is to determine if the use of home blood pressure monitors plus nurse telephone monitoring is more effective than the use of blood pressure monitors alone in improving control of high blood pressure in an urban medical clinic.

Participants will all have home blood pressure monitors, education session on controlling their blood pressure and will be randomized to recieve 6 months of intensive telephonic on a set monitoring schedule or no telephonic follow up. Phone calls will be weekly for 4 weeks, then every 2 weeks for 8 weeks then monthly for 3 months.

Inclusion Criteria:

• diagnosed with essential hypertension
• systolic blood pressure >140 mm Hg (130 if diabetic) OR diastolic blood pressure > 90 mm Hg (80 if diabetic)on at least 2 clinic visits prior to randomization
• BP at time of screening is > than systolic 140 (130 if diabetic) or diastolic 90 (80 if diabetic)
• patient is prescribed at least 1 antihypertensive medication
• Patient is fluent in English
• Patient is easily accessible by telephone

Exclusion Criteria:

• persons with stage 4 or 5 chronic kidney disease or end stage renal disease on dialysis
• Patients with a terminal illness
• Patients with severe dementia or serious mental illness
• Inability to preform self blood pressure monitoring
• Patient lacks a functioning home phone or personal cellular phone
• Pregnant or planning to get pregnant
• Arm circumference exceeds the allowable limit on the largest home BP monitor cuff