Prevalence of home blood pressure measurement among selected hypertensive patients : Results of a multicenter survey from six hospital outpatient hypertension clinics in Italy

Aim. The purpose of this study was to evaluate the prevalence of home blood pressure ( BP) measurement, the type of devices and accuracy in a large sample of hypertensive patients referred to hospital outpatient hypertension clinics. Methods. Eight hundred and fifty-five consecutive treated hypertensive patients who attended six specialized centers during a period of 4 months were included. They underwent the following procedures: ( i) detailed medical interview by a structured questionnaire; ( ii) physical examination; ( iii) standard 12-lead electrocardiogram; ( iv) BP measurements taken by a validated mercury sphygmomanometer and patient's devices. Results. A total of 640 ( 74.7%) of 855 patients were regularly performing home BP measurement. These patients were on average younger than those not practising it ( 58 vs 60 years, p < 0.01); men were more numerous than women ( 58 vs 44%, p = 0.03) and had higher educational level. Electronic arm-cuff instruments were the most frequently used devices ( 58%) followed by wrist devices ( 19%) and mercury or aneroid sphygmomanometers ( 23%). Significant correlations were found between BPs measured by validated mercury sphygmomanometers and patients' devices [ r = 0.85, p < 0.0001 for systolic BP ( SBP) and r = 0.78, p < 0.0001 for diastolic BP ( DBP)]. Differences <= 5 mmHg in SBP or DBP were found in 50 and 60% of patients, respectively. Conclusions. Our findings indicate that: ( i) home BP measurement is performed by a majority of treated hypertensives seen in specialized centers; ( ii) male gender, age and educational level seem to influence the adoption of home BP monitoring; ( iii) electronic arm-cuff devices are the most used instruments; ( iv) a notable fraction of patient's devices do not meet the accuracy criteria recommended by US Association for the Advancement of Medical Instrumentation.