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Home blood-pressure monitoring among hypertensive patients in an Asian population

Journal of Human Hypertension volume 19, pages 559–564 (2005)Cite this article

Abstract

Hypertension is a principal cause of mortality and morbidity in Singapore. The use of home blood-pressure monitoring (HBPM) to assess hypertensive control with digital devices in the local multi-racial population is unknown. The study determined the factors associated with hypertensive patients’ use of HBPM in primary care in a multi-racial Asian population. Randomized cross-sectional questionnaire survey of hypertensive patients managed in a district polyclinic. A model predicting use of HBPM was constructed by univariate and multivariate logistic regression. A total of 224 eligible subjects were randomly selected from 1943 patients. Response rate was 78.1% (n=175). In all, 61.7% of them were aware of HBPM but only 24% used HBPM. Using multivariate analysis by stepwise backward regression, the final fitted model showed that HBPM was associated with higher patients’ socioeconomic status: (adjusted OR for middle-income status=2.85, 95% CI: 1.2–6.78, P=0.018; adjusted OR for high-income status=3.46, 95% CI: 1.22–9.87, P=0.020) and their documented diastolic BP (adjusted OR for diastolic BP>80 mmHg=2.26, 95% CI: 1.06–4.82, P=0.034). Nonusers cited failure to recognize benefits (54.1%), lack of HBPM awareness (29.3%), understanding of device operation (18.8%) and perception of inaccuracy (10.5%) as deterrents. 76.2% of users were satisfied with HBPM but lacked knowledge in maintenance of devices. In conclusion, 61.7% of the study population were aware of HBPM but only 24% used it. Patients’ failure to recognize benefits, lack of awareness, cost and perception of inaccuracy were barriers. Higher socioeconomic status and patient's documented diastolic BP correlated with HBPM usage.

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Acknowledgements

We were grateful to the nurses, Vasanti, Violet and Mary, who rendered their assistance in data entry and the team of research nurses who interviewed the subjects in their residence. The study was supported by a small research grant from CTERU/NMRC.

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Authors and Affiliations

  1. SingHealth Polyclinics, Singapore

    N C Tan & R Pagi

  2. Clinical Trials and Epidemiological Unit, Singapore

    L W Khin

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  1. N C Tan
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  2. L W Khin
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  3. R Pagi
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Correspondence to N C Tan.

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Tan, N., Khin, L. & Pagi, R. Home blood-pressure monitoring among hypertensive patients in an Asian population. J Hum Hypertens 19, 559–564 (2005). https://doi.org/10.1038/sj.jhh.1001865

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