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 five general practices, three pharmacies, and one BP-checking provider. Participants received a BP monitor and training, then self-monitored BP on the first 3 days of each month for 6 months. Participants submitted their results to the research team. Outcome data were 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 perception scores significantly decreased (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, and limited socioeconomic diversity, limiting generalisability and highlighting the need for targeted outreach. BP self-monitoring for prehypertension is feasible in general practice, but requires further exploration with pharmacy, and community providers. These findings need confirming in an effectiveness trial.