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Randomised controlled trial
Home blood pressure monitoring with patient-initiated drug titration reduces blood pressure in high-risk patients with hypertension
  1. Steven M Smith1,2,
  2. Rhonda M Cooper-DeHoff1,3
  1. 1Department of Pharmacotherapy & Translational Research, College of Pharmacy;
  2. 2Department of Community Health & Family Medicine, College of Medicine;
  3. 3Division of Cardiovascular Medicine, Department of Medicine, College of Medicine, University of Florida, PO Box 100486, Gainesville, FL 32610, USA
  1. Correspondence to: Dr Steven M Smith, University of Florida, PO Box 100486, Gainesville, FL 32610, USA; ssmith{at}cop.ufl.edu

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Context

In patients with uncomplicated hypertension, home blood pressure (BP) monitoring combined with medication self-titration has been shown to substantially reduce BP.1 It is unknown whether a similar intervention is effective in high-risk patients with hypertension.

Methods

Patients (n=555) aged ≥35 years with a BP ≥130/80 mm Hg, but ≤180/100 mm Hg (treated with 0–3 antihypertensive drugs) and ≥1 high-risk condition were randomly assigned to home BP monitoring with patient-initiated drug titration (intervention arm) or standard care. In the intervention arm, patients and their general practitioner (GP) developed an individualised three-step titration plan at baseline. Patients then measured home BP daily for the first …

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