Article Document Information Content Entity Continuant Continuant Entity Entity Review Generically Dependent Continuant 2025-05-11T03:53:34 RDF description of Self-monitoring of blood pressure in patients with hypertension-related multi-morbidity: systematic review and individual patient data meta-analysis [meta-analysis, systematic review] - http://repository.healthpartners.com/individual/document-rn20352 Comorbidity <p>BACKGROUND: Studies have shown that self-monitoring of blood pressure (BP) is effective when combined with co-interventions, but its efficacy varies in the presence of some co-morbidities. This study examined whether self-monitoring can reduce clinic BP in patients with hypertension-related co-morbidity. METHODS: A systematic review was conducted of articles published in Medline, Embase, and the Cochrane Library up to January 2018. Randomized controlled trials of self-monitoring of BP were selected and individual patient data (IPD) were requested. Contributing studies were prospectively categorized by whether they examined a low/high-intensity co-intervention. Change in BP and likelihood of uncontrolled BP at 12 months were examined according to number and type of hypertension-related co-morbidity in a one-stage IPD meta-analysis. RESULTS: A total of 22 trials were eligible, 16 of which were able to provide IPD for the primary outcome, including 6,522 (89%) participants with follow-up data. Self-monitoring was associated with reduced clinic systolic BP compared to usual care at 12-month follow-up, regardless of the number of hypertension-related co-morbidities (-3.12 mm Hg, [95% confidence intervals -4.78, -1.46 mm Hg]; P value for interaction with number of morbidities = 0.260). Intense interventions were more effective than low-intensity interventions in patients with obesity (P < 0.001 for all outcomes), and possibly stroke (P < 0.004 for BP control outcome only), but this effect was not observed in patients with coronary heart disease, diabetes, or chronic kidney disease. CONCLUSIONS: Self-monitoring lowers BP regardless of the number of hypertension-related co-morbidities, but may only be effective in conditions such obesity or stroke when combined with high-intensity co-interventions.<p> 3 systematic review Randomized Controlled Trials 33 16680 American Journal of Hypertension Risk Factors Heart Disease Hypertension meta-analysis public Self-monitoring of blood pressure in patients with hypertension-related multi-morbidity: systematic review and individual patient data meta-analysis [meta-analysis, systematic review] 27880 Monitoring, Physiologic Diabetes Drugs and Drug Therapy document-rn20352 10.1093/ajh/hpz182 Self Care Stroke 2022-02-21T22:48:57.408-06:00