How feasible is self-monitoring for the management of prehypertension? The REVERSE study.

Abstract

Prehypertension (blood pressure (BP) 120-139/80-89 mmHg) affects 40% of UK adults increasing cardiovascular risk. While BP self-monitoring is effective in hypertension, its feasibility in prehypertension is unclear. Concerns include lack of interest, medicalisation and unintended consequences, despite evidence suggesting it may empower individuals in risk management and prevention. To determine the feasibility of BP self-monitoring for prehypertension. A prospective, non-randomised, mixed-methods, feasibility study across primary care in Lancashire and South Cumbria. People with prehypertension were recruited from 5 general practices, 3 pharmacies and 1 BP-checking provider. Participants received a BP monitor and training, then self-monitored BP on the first three days of each month for six months. Participants submitted their results to the research team. Outcome data was collected at baseline, 6-months and 12-months and analysed mainly using descriptive statistics. Of 162 expressions of interest, 80 were eligible and consented; 78 from general practice, one each from pharmacy and community providers. Of those recruited, 66 (83%) and 33 (41%) completed 6-month and 12-month follow-up, respectively, with minimal missing data. No adverse effects were reported. Illness perceptions significantly improved (Mean 26.6 (SD 8.6) to Mean 22.6 (SD 8.7), <i>P</i>=0.002), with no other significant changes. There was only one non-white participant. BP self-monitoring for prehypertension is feasible in general practice, but requires further exploration with pharmacy, and community providers. The homogenous sample limits generalisability highlighting the need for targeted outreach Findings need confirming in an effectiveness trial.