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Home CHEP Recommendations Details Home Measurement

Home Measurement

  1. Home BP readings can be used in the diagnosis of hypertension (Grade C).
  2. The use of home BP monitoring on a regular basis should be considered for patients with hypertension, particularly those with:
    • diabetes mellitus (Grade D);
    • chronic kidney disease (Grade C);
    • suspected nonadherence (Grade D);
    • demonstrated white coat effect (Grade C); and
    • BP controlled in the office but not at home (masked hypertension) (Grade C).
  3. When white coat hypertension is suggested by home monitoring, its presence should be confirmed with ABPM before making treatment decisions (Grade D).
  4. Patients should be advised to purchase and use only home BP monitoring devices that are appropriate for the individual and have met standards of the Association for the Advancement of Medical Instrumentation, the most recent requirements of the British Hypertension Society protocol, or the International Protocol for validation of automated BP measuring devices. Patients should be encouraged to use devices with data recording capabilities or automatic data transmission to increase the reliability of reported home BP values (Grade D).
  5. Home SBP values >135 mmHg or DBP values >85 mmHg should be considered elevated and associated with an increased overall mortality risk analogous to office SBP readings of >140 mmHg or DBP >90 mmHg (Grade C).
  6. Health care professionals should ensure that patients who measure their BP at home have adequate training, and, if necessary, repeat training in measuring their BP. Patients should be observed to determine that they measure BP correctly and they should be given adequate information about interpreting these readings (Grade D).
  7. The accuracy of all individual patients’ validated devices (including electronic devices) must be regularly checked against a device of known calibration (Grade D).
  8. Home BP values for assessing white coat hypertension or sustained hypertension should be based on duplicate measures, morning and evening, for an initial seven-day period. First day home BP values should not be considered (Grade D).