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Cited by 17Blood Pressure and Hypertension StudiesMedication Adherence and ComplianceSodium Intake and Health

Effect of Home Medication Titration on Blood Pressure Control in Patients With Hypertension: A Meta-Analysis of Randomized Controlled Trials

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Chen, Ting-Yu, Kao, Chi-Wen, Cheng, Shu-Meng, Chang, Yue-Cune·2019·Medical Care
DOI 10.1097/mlr.0000000000001064PMC PMC6410972
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Abstract

Background: Medication titration has been used in home blood pressure (BP) control, with the expectation of enabling patients with hypertension to better manage their BP. Objective: The study goal was to estimate the effects of medication titration intervention in lowering the systolic blood pressure and diastolic blood pressure of patients with hypertension. Methods: The meta-analysis included randomized controlled trials on adults diagnosed with hypertension and BP≧130/80 mm Hg, having a medication-titration intervention, and using a home BP measurement. We systematically searched PubMed, CINAHL, Ovid-Medline, and the Cochrane Library, for studies published from 1997 to 2017. The quality of the studies was evaluated by the Modified Jadad scale. Statistical heterogeneity among the trials was evaluated using Q statistics and I 2. Publication bias was assessed with the funnel plot and Rosenthal’s fail-safe N. Results: The meta-analysis included 4 studies randomizing 1335 participants. Medication-titration intervention significantly assisted hypertensive patients to improve BP control; systolic blood pressure was reduced by 6.86 mm Hg [95% confidence interval (CI), 4.80-8.93, P<0.0001] and diastolic blood pressure by 3.03 mm Hg (95% CI, 2.07-3.99, P<0.0001), did not significantly affect EQ-5D scores (mean difference, 0.02; 95% CI, −0.01 to 0.04, P=0.13). Conclusions: Our findings suggest home medication titration of antihypertensive medication for hypertensive patients significantly improved home BP control. However, the strategy did not enhance quality of life in patients with hypertension.

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  • In 2014, a study randomizing patients with untreated hypertension to management based on clinic and ABPM measurement or HBPM alone showed no significant difference between groups in LVMI regression after 1 year.

    “In 2014, a study, which randomized patients with untreated hypertension to management based on clinic and ABPM measurement or HBPM alone showed that after 1 year, there was no significant difference between groups in LVMI regression. [160,161]”

    From Home blood pressure monitoring: methodology, clinical relevance and practical application: a 2021 position paper by the Working Group on Blood Pressure Monitoring and Cardiovascular Variability of the European Society of Hypertension (2021) · cites this paper as [160]

    The Results (Characteristics of Included Trials and Effect on BP Control; page not provided) describe a meta-analysis of medication-titration trials and report blood-pressure outcomes, not LVMI regression. The Discussion and References mention home monitoring, but searches for LVMI regression and ambulatory monitoring found no account of the claimed 2014 comparison or its one-year outcome. (LLM, conf=0.76)

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Cited by

Sorted by citations

Authors
Chen, T.-Y., Kao, C.-W., Cheng, S.-M., & Chang, Y.-C.
Affiliations
  • National Defense Medical Center (TW)
  • Tri-Service General Hospital (TW)
  • Tamkang University (TW)
Corresponding author
Chen, Ting-Yu
ORCID
Venue
Medical Care
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2019-03
Volume
57
Issue
3
Pages
230-236
ISSN
0025-7079 (ISSN-L)
DOI
10.1097/mlr.0000000000001064
PMC
PMC6410972
OpenAlex
W2914205739
Cited by
17
References
5
Citations by year
2026: 2 · 2025: 3 · 2024: 3 · 2023: 1 · 2022: 2 · 2021: 4 · 2020: 1 · 2019: 1
FWCI
0.36
Type
journal article
Language
en
Open access
Licence
Locations
  • Medical Care (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Tamkang University Institutional Repository (TKUIR) (submittedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
  • Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
Keywords
hypertension, dose titration, home blood pressure monitoring, antihypertensive drugs, blood pressure control, systolic blood pressure, diastolic blood pressure, quality of life, EQ-5D
MeSH terms
Antihypertensive Agents, Blood Pressure, Home Care Services, Humans, Hypertension, Quality of Life, Self Care, Randomized Controlled Trials as Topic

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