Uneven accuracy of home blood pressure measurement: a multi-centric survey

Home blood pressure is increasingly commonly performed, but the concordance between patient HBPM measurement technique and prevailing recommendations has not been well assessed from our appraisal of the literature. We performed a multi-centric survey to evaluate the degree of patients' adherence to current recommendations on HBPM, and investigate potential predictors of a higher-quality self-measurement. A structured questionnaire was administered to 725 Italian outpatient hypertensive subjects (mean age 52.2±14.4y). Overall, ≥10 recommended procedures were followed by 52.8% of the participants; only 1.0% followed all recommendations. 49.7% of the participants rested for ≥5 minutes before the measurement, 36.8% recorded BP more than once in each measurement session, 34.3% used a chair or bed saddle to support their back. Less than 40% of the patients received some form of training by health professionals. At multivariate analysis, patients receiving/reading instructions showed higher-quality HBPM (p<0.01). The accuracy of HBPM needs to be improved, and more efforts should be devoted to provide patients’ training on HBPM, especially on the less frequently followed recommendations