Efficacy of Home Blood Pressure Monitoring (MONITOR Study)

Efficacy of Home Blood Pressure Monitoring to Improve Blood Pressure Control: a Randomized Controlled Trial With Ambulatory Blood Pressure Measurement

High blood pressure is the main risk factor for cardiovascular disease worldwide,but its control rate is unsatisfactory. Home Blood Pressure Monitoring (HBPM) with automatic oscillometric devices and pharmaceutical care have been proposed as interventions to increase therapeutic compliance and to guide treatment decisions.

The purpose of this study is to evaluate the effect of HBPM and of pharmaceutical care in blood pressure control measured through 24h ambulatory blood pressure monitoring (ABPM).

Home Blood Pressure Monitoring (HBPM) and Pharmaceutical care have been proposed to improve therapeutic compliance and to guide treatment decisions, but their effects on BP control are still under debate.

This is a factorial randomized controlled trial including adult hypertensive patients under drug treatment but with office BP and 24h ABPM uncontrolled. Participants will be allocated to one of four groups: HBPM; HBPM and Pharmaceutical care; Pharmaceutical care; or control. All participants will receive usual care for high blood pressure. Participants will be followed for 60 days.

Inclusion Criteria:

• Office BP ≥140/90 mm Hg
• 24h ABPM hypertension BP ≥130/80 mm Hg
• using at least one antihypertensive drug

Exclusion Criteria:

• BP ≥ 180 / 110 mmHg)
• major cardiovascular events in the last six months
• acute or chronic diseases limiting the capacity to understand and to participate in the trial
• masked hypertension
• white-coat hypertension
• secondary hypertension
• pregnancy
• breastfeeding
• concurrent participation in another trial