Nye Rebecca, Lehmann Wilhelm, Simpson Deborah
Training in Urban Medicine and Public Health (TRIUMPH) MD Program; University of Wisconsin School of Medicine and Public Health, Milwaukee, WI.
Family Medicine, Advocate Aurora Health, Milwaukee, WI.
J Patient Cent Res Rev. 2022 Jul 18;9(3):185-190. doi: 10.17294/2330-0698.1944. eCollection 2022 Summer.
African Americans are disproportionately affected by hypertension, a modifiable contributor to multiple chronic diseases and premature death. Primary care physicians play an important role in hypertension control. Home blood pressure monitoring (HBPM) is an evidence-based method for confirming diagnosis and monitoring hypertension over time. Some studies have found that HBPM may lead to clinically relevant reductions in blood pressure when combined with additional interventions, but few studies have focused specifically on African American populations. Evidence of effectiveness could increase clinical recommendation of HBPM. This clinical inquiry examined whether HBPM improves blood pressure control in African Americans with uncontrolled hypertension. Reviewed studies included 4 randomized controlled trials and 2 comparative research studies. Because these studies often were coupled with various co-interventions, ascertaining the independent effects of HBPM was difficult. When examining reviews of HBPM without a co-intervention and conducted independent of race, HBPM alone was insufficient to achieve long-term changes in hypertension control. More research focused on African Americans, with use of control groups, is needed to determine the true role for HBPM in controlling hypertension in this at-risk patient population.
非裔美国人受高血压影响的比例过高，高血压是多种慢性疾病和过早死亡的一个可改变的促成因素。初级保健医生在高血压控制中发挥着重要作用。家庭血压监测（HBPM）是一种基于证据的方法，用于确诊高血压并长期监测病情。一些研究发现，HBPM与其他干预措施相结合时，可能会使血压在临床上出现显著下降，但很少有研究专门针对非裔美国人。有效性证据可能会增加HBPM的临床推荐。这项临床研究探讨了HBPM是否能改善高血压未得到控制的非裔美国人的血压控制情况。所审查的研究包括4项随机对照试验和2项比较研究。由于这些研究常常与各种联合干预措施相结合，因此很难确定HBPM的独立效果。在审查无联合干预且独立于种族进行的HBPM研究时，单独使用HBPM不足以实现高血压控制的长期改变。需要开展更多针对非裔美国人且设有对照组的研究，以确定HBPM在控制这一高危患者群体的高血压方面的真正作用。
