Home measurement of blood pressure (BP) is now an accepted norm. The question addressed in a new clinical trial is: can the elderly, never before specifically tested, carry out home BP monitoring over the long term, or would age-related physical or cognitive infirmity lead to failure.
“Hard data” on this seemingly obvious question should be quite valuable, because many strategies designed to help people lower their BP rely on home monitoring for providing BP feedback to doctors and nurses and for motivating older people to adhere to their recommended medication and lifestyle regimens.
The answer, from a three-city French study of 1,814 community-dwelling individuals aged 73 years and older, is yes, the elderly can reliably check their BP at home—with a few caveats.
After training and three-day feasibility testing, during which participants were instructed to carry out six measurements a day, patients were sent home with an Omron M6 device (which has been validated for use in clinical trials), an instruction booklet, and a logbook in which to record six-a-day BPs over the next year.
At one-year follow-up, 96% of the participants were considered successes. Three variables were linked to higher risk of failure: age more than 80 years, less than 12 years of formal education, and lack of autonomy, defined as not being totally independent for activities of daily living.
To confirm reliability of the success rate, the investigators compared entries in the patient’s logbook with the BP device’s memory (it can retain 90 readings) for half the trial population, with excellent concordance.
In actual daily life, the success rate might be lower, the researchers acknowledge, as their study population was highly educated and very healthy for their age brackets.
Nevertheless, the results of the trial support the widespread use of home BP measurement in the elderly, the team concludes, so long as the very old, the undereducated, and the nonautonomous receive special attention.
Cacciolati C, Tzourio C, Dufouil C, Alpérovitch A, Hanon O. Feasibility of home blood pressure measurement in elderly individuals: cross-sectional analysis of a population-based sample. Am J Hypertens 2012;25;1279-1285.
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