Home monitoring of blood pressure in children, pregnancy, and chronic kidney diseases via personal blood pressure meters- An updated review for pharmacists
Keywords:
blood pressure monitoring, home monitoring, hypertension, children, pregnancy, chronic kidney disease, preeclampsiaAbstract
Background: Blood pressure (BP) monitoring is critical in managing hypertension across various populations, including children, pregnant women, and patients with chronic kidney disease (CKD). Traditional clinic-based BP measurements often lead to misdiagnoses due to white-coat and masked hypertension. Aim: This review highlights the significance of home BP monitoring in children, pregnancy, and CKD, evaluating its accuracy, practicality, and integration into clinical practice. Methods: A literature review was conducted, analyzing studies on home BP monitoring across pediatric, pregnancy, and CKD populations. Data on oscillometric devices and validation studies were included. Results: Home BP monitoring is increasingly used in pediatric hypertension, with an 80–85% agreement with ambulatory monitoring. In pregnancy, home monitoring aids in detecting preeclampsia and helps maintain optimal BP levels. For CKD, home BP readings are superior to clinical measurements, accurately predicting disease progression and cardiovascular risk. Conclusion: Home BP monitoring proves valuable in managing hypertension across vulnerable populations, offering convenience, reliability, and better diagnostic precision. Further research is needed to refine device accuracy and integrate home monitoring into routine care for children, pregnant women, and CKD patients.
Downloads
References
Lurbe E, Agabiti-Rosei E, Cruickshank JK, Dominiczak A, Erdine S, Hirth A, et al. 2016 European Society of Hypertension guidelines for the management of high blood pressure in children and adolescents. J Hypertens. 2016;34:1887–920. DOI: https://doi.org/10.1097/HJH.0000000000001039
Flynn JT, Kaelber DC, Baker-Smith CM, Blowey D, Carroll AE, Daniels SR, et al. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics. 2017;140:pii: e20171904. DOI: https://doi.org/10.1542/peds.2017-3035
Stergiou GS, Alamara CV, Vazeou A, Stefanidis CJ. Office and out-of-office blood pressure measurement in children and adolescents. Blood Press Monit. 2004;9:293–6. DOI: https://doi.org/10.1097/00126097-200412000-00004
Stergiou GS, Ntineri A, Kollias A, Stambolliu E, Kapogiannis A, Vazeou A, et al. Home blood pressure monitoring in pediatric hypertension: the US perspective and a plan for action. Hypertens Res. 2018;41:662–8. DOI: https://doi.org/10.1038/s41440-018-0078-5
Stergiou GS, Ntineri A. Methodology and applicability of home blood pressure monitoring in children and adolescents. In: Flynn J, Ingelfinger J, Redwine K, editors. Pediatric Hypertension. Cham: Springer; 2018. p. 305–21. https://doi.org/10.1007/978-3-319-31107-4_45. DOI: https://doi.org/10.1007/978-3-319-31107-4_45
Bald M, Hoyer PF. Measurement of blood pressure at home: survey among pediatric nephrologists. Pediatr Nephrol. 2001;16:1058–62. DOI: https://doi.org/10.1007/s004670100027
Woroniecki RP, Flynn JT. How are hypertensive children evaluated and managed? A survey of North American pediatric nephrologists. Pediatr Nephrol. 2005;20:791–7. DOI: https://doi.org/10.1007/s00467-004-1804-6
Stergiou GS, Alamara CV, Salgami EV, Vaindirlis IN, Dacou-Voutetakis C, Mountokalakis TD. Reproducibility of home and ambulatory blood pressure in children and adolescents. Blood Press Monit. 2005;10:143–7. DOI: https://doi.org/10.1097/00126097-200506000-00005
Stergiou GS, Nasothimiou EG, Giovas PP, Rarra VC. Long-term reproducibility of home vs. office blood pressure in children and adolescents: the Arsakeion school study. Hypertens Res. 2009;32:311–5. DOI: https://doi.org/10.1038/hr.2009.9
Stergiou GS, Nasothimiou E, Giovas P, Kapoyiannis A, Vazeou A. Diagnosis of hypertension in children and adolescents based on home versus ambulatory blood pressure monitoring. J Hypertens. 2008;26:1556–62. DOI: https://doi.org/10.1097/HJH.0b013e328301c411
Stergiou GS, Giovas PP, Kollias A, Rarra VC, Papagiannis J, Georgakopoulos D, et al. Relationship of home blood pressure with target-organ damage in children and adolescents. Hypertens Res. 2011;34:640–4. DOI: https://doi.org/10.1038/hr.2011.10
Kollias A, Dafni M, Poulidakis E, Ntineri A, Stergiou GS. Out-of-office blood pressure and target organ damage in children and adolescents: a systematic review and meta-analysis. J Hypertens. 2014;32:2315–31. DOI: https://doi.org/10.1097/HJH.0000000000000384
Stergiou GS, Boubouchairopoulou N, Kollias A. Accuracy of automated blood pressure measurement in children: evidence, issues, and perspectives. Hypertension. 2017;69:1000–6. DOI: https://doi.org/10.1161/HYPERTENSIONAHA.116.08553
Stergiou GS, Yiannes NG, Rarra VC, Panagiotakos DB. Home blood pressure normalcy in children and adolescents: the Arsakeion School study. J Hypertens. 2007;25:1375–9. DOI: https://doi.org/10.1097/HJH.0b013e328122d3fc
Stergiou GS, Yiannes NG, Rarra VC. Validation of the Omron 705 IT oscillometric device for home blood pressure measurement in children and adolescents: the Arsakion School study. Blood Press Monit. 2006;11:229–34. DOI: https://doi.org/10.1097/01.mbp.0000209074.38331.16
Stergiou GS, Karpettas N, Panagiotakos DB, Vazeou A. Comparison of office, ambulatory and home blood pressure in children and adolescents on the basis of normalcy tables. J Hum Hypertens. 2011;25:218–23. DOI: https://doi.org/10.1038/jhh.2010.59
Stergiou GS, Christodoulakis G, Giovas P, Lourida P, Alamara C, Roussias LG. Home blood pressure monitoring in children: how many measurements are needed? Am J Hypertens. 2008;21:633–8. DOI: https://doi.org/10.1038/ajh.2008.38
Nathan HL, Duhig K, Hezelgrave NL, Chappell LC, Shennan AH. Blood pressure measurement in pregnancy. Obstet Gynaecol. 2015;17:91–8. DOI: https://doi.org/10.1111/tog.12173
Duley L. The global impact of pre-eclampsia and eclampsia. Semin Perinatol. 2009;33:130–7. DOI: https://doi.org/10.1053/j.semperi.2009.02.010
Shennan AH, Green M, Chappell LC. Maternal deaths in the UK: pre-eclampsia deaths are avoidable. Lancet. 2017;389:582–4. DOI: https://doi.org/10.1016/S0140-6736(17)30184-8
Shennan A, Gupta M, Halligan A, Taylor DJ, de Swiet M. Lack of reproducibility in pregnancy of Korotkoff phase IV as measured by mercury sphygmomanometry. Lancet. 1996;347:139–42. DOI: https://doi.org/10.1016/S0140-6736(96)90338-4
Nathan HL, Vousden N, Lawley E, de Greeff A, Hezelgrave NL, Sloan N, et al. Development and evaluation of a novel vital signs alert device for use in pregnancy in low-resource settings. BMJ Innov. 2018;4:192–8. DOI: https://doi.org/10.1136/bmjinnov-2017-000235
Tucker KL, Bankhead C, Hodgkinson J, Roberts N, Stevens R, Heneghan C, et al. How do home and clinic blood pressure readings compare in pregnancy? Hypertension. 2018;72:686–94. DOI: https://doi.org/10.1161/HYPERTENSIONAHA.118.10917
von Dadelszen P, Ornstein MP, Bull SB, Logan AG, Koren G, Magee LA. Fall in mean arterial pressure and fetal growth restriction in pregnancy hypertension: a meta-analysis. Lancet. 2000;355:87–92. DOI: https://doi.org/10.1016/S0140-6736(98)08049-0
Bellamy L, Casas JP, Hingorami AD, Williams DJ. Preeclampsia and risk of cardiovascular disease and cancer in later life: systematic review and meta-analysis. BMJ. 2007;335:974. DOI: https://doi.org/10.1136/bmj.39335.385301.BE
Magee L, von Dadelszen P. Preeclampsia and increased cardiovascular risk. BMJ. 2007;335:945–6. DOI: https://doi.org/10.1136/bmj.39337.427500.80
Rolnik DL, Wright D, Poon LC, O'Gorman N, Syngelaki A, de Paco Matallana C, et al. Aspirin versus placebo in pregnancies at high risk for preterm preeclampsia. N Engl J Med. 2017;377:613–22. DOI: https://doi.org/10.1056/NEJMoa1704559
Ross-McGill H, Hewison J, Hirst J, Dowswell T, Holt A, Brunskill P, et al. Antenatal home blood pressure monitoring: a pilot randomised controlled trial. BJOG. 2000;107:217–21. DOI: https://doi.org/10.1111/j.1471-0528.2000.tb11692.x
Andersen MJ, Khawandi W, Agarwal R. Home blood pressure monitoring in CKD. Am J Kidney Dis. 2005;45:994–1001. DOI: https://doi.org/10.1053/j.ajkd.2005.02.015
Rave K, Bender R, Heise T, Sawicki PT. Value of blood pressure self-monitoring as a predictor of progression of diabetic nephropathy. J Hypertens. 1999;17:597–601. DOI: https://doi.org/10.1097/00004872-199917050-00002
Agarwal R, Andersen MJ. Prognostic importance of clinic and home blood pressure recordings in patients with chronic kidney disease. Kidney Int. 2006;69:406–11. DOI: https://doi.org/10.1038/sj.ki.5000081
Santos SF, Mendes RB, Santos CA, Dorigo D, Peixoto AJ. Profile of interdialytic blood pressure in hemodialysis patients. Am J Nephrol. 2003;23:96–105. DOI: https://doi.org/10.1159/000068038
Agarwal R, Lewis RR. Prediction of hypertension in chronic hemodialysis patients. Kidney Int. 2001;60:1982–9. DOI: https://doi.org/10.1046/j.1523-1755.2001.00997.x
Agarwal R, Peixoto AJ, Santos SF, Zoccali C. Pre and post dialysis blood pressures are imprecise estimates of interdialytic ambulatory blood pressure. Clin J Am Soc Nephrol. 2006;1:389–98. DOI: https://doi.org/10.2215/CJN.01891105
Alborzi P, Patel N, Agarwal R. Home blood pressures are of greater prognostic value than hemodialysis unit recordings. Clin J Am Soc Nephrol. 2007;2:1228–34. DOI: https://doi.org/10.2215/CJN.02250507
Agarwal R. Blood pressure and mortality among hemodialysis patients. Hypertension. 2010;55:762–8. DOI: https://doi.org/10.1161/HYPERTENSIONAHA.109.144899
Agarwal R, Light RP. Chronobiology of arterial hypertension in hemodialysis patients: implications for home blood pressure monitoring. Am J Kidney Dis. 2009;54:693–701. DOI: https://doi.org/10.1053/j.ajkd.2009.03.018
da Silva GV, de Barros S, Abensur H, Ortega KC, Mion D Jr. Cochrane renal group prospective trial register: CRG060800146. Home blood pressure monitoring in blood pressure control among haemodialysis patients: An open randomized clinical trial. Nephrol Dial Transplant. 2009;24:3805–11. DOI: https://doi.org/10.1093/ndt/gfp332
Bishu K, Gricz KM, Chewaka S, Agarwal R. Appropriateness of antihypertensive drug therapy in hemodialysis patients. Clin J Am Soc Nephrol. 2006;1:820–4. DOI: https://doi.org/10.2215/CJN.00060106
Agarwal R, Sinha AD, Pappas MK, Abraham TN, Tegegne GG. Hypertension in hemodialysis patients treated with atenolol or lisinopril: a randomized controlled trial. Nephrol Dial Transplant. 2014;29:672–81. DOI: https://doi.org/10.1093/ndt/gft515
Agarwal R, Andersen MJ, Light RP. Location not quantity of blood pressure measurements predicts mortality in hemodialysis patients. Am J Nephrol. 2007;28:210–7. DOI: https://doi.org/10.1159/000110090
Liyanage-Don, N., Fung, D., Phillips, E., & Kronish, I. M. (2019). Implementing home blood pressure monitoring into clinical practice. Current hypertension reports, 21, 1-14. DOI: https://doi.org/10.1007/s11906-019-0916-0
Published
How to Cite
Issue
Section
Copyright (c) 2020 International journal of health sciences
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Articles published in the International Journal of Health Sciences (IJHS) are available under Creative Commons Attribution Non-Commercial No Derivatives Licence (CC BY-NC-ND 4.0). Authors retain copyright in their work and grant IJHS right of first publication under CC BY-NC-ND 4.0. Users have the right to read, download, copy, distribute, print, search, or link to the full texts of articles in this journal, and to use them for any other lawful purpose.
Articles published in IJHS can be copied, communicated and shared in their published form for non-commercial purposes provided full attribution is given to the author and the journal. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
This copyright notice applies to articles published in IJHS volumes 4 onwards. Please read about the copyright notices for previous volumes under Journal History.
