Attitudes of primary care physicians and their patients about home blood pressure monitoring in Ontario
Abstract
OBJECTIVE: Guidelines recommend home blood pressure monitoring (HBPM) to improve blood pressure control, but the attitudes of primary care physicians and their hypertensive patients towards its use are not known. METHODS: A 28-item self-administered survey about home blood pressure monitoring was mailed to a random sample of 1418 primary care physicians in Ontario and 765 (55%) were returned. Of the 478 physicians treating hypertension, 299 agreed to give surveys to their hypertensive patients. We received 149 patient surveys. RESULTS: The majority of primary care physicians (63%) often or almost always encouraged their hypertensive patients to monitor their own blood pressure at home. Only 13%, however, preferred home blood pressure monitoring to office or ambulatory readings for diagnostic purposes and 19%, to guide therapy. Physicians had concerns about patients becoming preoccupied with home monitoring (70%) and the accuracy of home devices (65%). Most patients (78%) had a device at home, and 84% indicated that their doctor encouraged them to measure blood pressure. Yet, 80% received no advice from their physician on the type of device to purchase, only 8% had specific training on proper measurement technique, 68% did not regularly take the results to the doctor and 39% did nothing specific about alarming readings. CONCLUSIONS: Primary care physicians prefer office or ambulatory to home readings to make diagnostic and therapeutic decisions. While home monitoring is popular among patients, its clinical usefulness is undermined by the lack of reliable purchasing information, standard measurement protocols, proper training on measurement technique and specific instructions on handling and interpreting results.
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Adoption of HBPM is still challenging because of barriers that involve cultural, structural and financial domains.
“Adoption of HBPM is still challenging because of barriers that involve three general domains: cultural, structural and financial [255–258].”
Results of the IDHOCO study indicate that risk of cardiovascular morbidity and mortality steeply increased in the highest decile of systolic/diastolic HBPV distribution (CV ≥11/12.8%, respectively).
“the results of the IDHOCO study indicate that the risk of cardiovascular morbidity and mortality steeply increased in the highest decile of systolic/diastolic HBPV distribution (CV ≥11/12.8%, respectively) [252].”
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- Authors
- Logan, A. G., Dunai, A., McIsaac, W. J., Irvine, M. J., & Tisler, A.
- Affiliations
- Mount Sinai Hospital (CA)
- Lunenfeld-Tanenbaum Research Institute (CA)
- York University (CA)
- Corresponding author
- Logan, Alexander G
- Venue
- Journal of Hypertension
- Published
- 2008-03
- Volume
- 26
- Issue
- 3
- Pages
- 446-452
- ISSN
- 0263-6352 (ISSN-L)
- OpenAlex
- W2008204665
- Cited by
- 106
- References
- 4
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 3 · 2023: 6 · 2022: 5 · 2021: 9 · 2020: 11 · 2019: 10 · 2018: 6 · 2017: 5 · 2016: 1 · 2015: 12 · 2014: 5 · 2013: 4 · 2012: 4
- FWCI
- 5.11
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Keywords
- home blood pressure monitoring, hypertension, primary care physicians, patient attitudes, physician attitudes, blood pressure control, ambulatory blood pressure monitoring, physician-patient communication, Ontario
- MeSH terms
- Aged, Attitude, Attitude of Health Personnel, Attitude to Health, Female, Humans, Hypertension, Male, Middle Aged, Ontario, Physicians, Family, Primary Health Care, Blood Pressure Monitors, Blood Pressure Monitoring, Ambulatory
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