Response to Home or Office Blood Pressure Monitoring in Predicting Cardiovascular Events: What is Policy Implication?
We appreciate the comments made by Shiue1 concerning our article and also healthcare policy in general. We do not feel that the times of measurement for home and office blood pressure (BP) used in our study are a limitation because they are similar to those used in real-life clinical practice.
It has also been demonstrated that the use of home BP measurement by itself could lead to better BP control.2 However, the follow-up of lifestyle changes was not necessary in our study because this was not an interventional study. Both office and home BPs were measured in all of the study participants only at the beginning of the follow-up.
We acknowledge the fact that only a very few studies concerning home BP measurement have been performed in developing countries and agree that more studies carried out in these countries are required. We also concur that the most important issue in BP measurement is that everyone’s BP is measured on a regular basis, no matter what the method may be. However, if home BP monitors are available, we feel that office BP measurement should be used mainly for screening purposes. Because of its several advantages that are mentioned in our article, home BP measurement should become the method of choice for diagnosing and treating hypertension.3
Shiue I. Home or office blood pressure monitoring in predicting cardiovascular events: what is policy implication? Hypertension. 2010; 56: e13.
Cappuccio FP, Kerry SM, Forbes L, Donald A. Blood pressure control by home monitoring: meta-analysis of randomised trials. BMJ. 2004; 329: 145–151.
Niiranen TJ, Hänninen MR, Johansson J, Reunanen A, Jula AM. Home-measured blood pressure is a stronger predictor of cardiovascular risk than office blood pressure: the Finn-Home Study. Hypertension. 2010; 55: 1346–1351.