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

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Abstract

The present paper provides an update of previous recommendations on Home Blood Pressure Monitoring from the European Society of Hypertension (ESH) Working Group on Blood Pressure Monitoring and Cardiovascular Variability sequentially published in years 2000, 2008 and 2010. This update has taken into account new evidence in this field, including a recent statement by the American Heart association, as well as technological developments, which have occurred over the past 20 years. The present document has been developed by the same ESH Working Group with inputs from an international team of experts, and has been endorsed by the ESH.

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Most cited references 292

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2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary

Paul K. Whelton, Robert Carey, Wilbert Aronow … (2018)

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Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents

Joseph T Flynn, David Kaelber, Carissa Baker-Smith … (2017)

These pediatric hypertension guidelines are an update to the 2004 "Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents." Significant changes in these guidelines include (1) the replacement of the term "prehypertension" with the term "elevated blood pressure," (2) new normative pediatric blood pressure (BP) tables based on normal-weight children, (3) a simplified screening table for identifying BPs needing further evaluation, (4) a simplified BP classification in adolescents ≥13 years of age that aligns with the forthcoming American Heart Association and American College of Cardiology adult BP guidelines, (5) a more limited recommendation to perform screening BP measurements only at preventive care visits, (6) streamlined recommendations on the initial evaluation and management of abnormal BPs, (7) an expanded role for ambulatory BP monitoring in the diagnosis and management of pediatric hypertension, and (8) revised recommendations on when to perform echocardiography in the evaluation of newly diagnosed hypertensive pediatric patients (generally only before medication initiation), along with a revised definition of left ventricular hypertrophy. These guidelines include 30 Key Action Statements and 27 additional recommendations derived from a comprehensive review of almost 15 000 published articles between January 2004 and July 2016. Each Key Action Statement includes level of evidence, benefit-harm relationship, and strength of recommendation. This clinical practice guideline, endorsed by the American Heart Association, is intended to foster a patient- and family-centered approach to care, reduce unnecessary and costly medical interventions, improve patient diagnoses and outcomes, support implementation, and provide direction for future research.

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2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC).

Giuseppe Mancia, Robert Fagard, Krzysztof Narkiewicz … (2013)

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Author and article information

Journal

Journal ID (nlm-ta): J Hypertens

Journal ID (iso-abbrev): J Hypertens

Journal ID (publisher-id): JHYPE

Title: Journal of Hypertension

Publisher: Lippincott Williams & Wilkins (Hagerstown, MD )

ISSN (Print): 0263-6352

ISSN (Electronic): 1473-5598

Publication date (Print): September 2021

Publication date (Electronic): 26 July 2021

Volume: 39

Issue: 9

Pages: 1742-1767

Affiliations

[a ]Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Department of Cardiovascular Neural and Metabolic Sciences

[b ]Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy

[c ]Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Athens, Greece

[d ]Division of Nephrology, Department of Medicine, Indiana University School of Medicine and Richard L. Roudebush Veterans Administration Medical Center, Indianapolis, Indiana, USA

[e ]Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan

[f ]Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium

[g ]Tohoku Institute for the Management of Blood Pressure, Sendai, Japan

[h ]Foundation-Medical Research Institutes, Geneva

[i ]Service of Nephrology and Hypertension, University Hospital, Lausanne, Switzerland

[j ]Hypertension Unit, Department of Internal Medicine, Hospital Mútua Terrassa, University of Barcelona, Barcelona, Spain

[k ]Cardiology IV, ‘A. De Gasperis” Department, ASTT GOM Niguarda Ca’ Granda

[l ]Cardiology/Hypertension Unit Saint André Hospital. University Hospital of Borfeaux, France

[m ]Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia

[n ]Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan

[o ]Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China

[p ]Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Alexandra Hospital, Athens, Greece

[q ]Primary Care Unit, Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK

[r ]Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK

[s ]Kerckhoff Clinic, Rehabilitation, ESH Excellence Centre, Bad Nauheim, Germany

[t ]Department of Cardiology and Kolling Institute, Royal North Shore Hospital, St Leonards Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia

[u ]Hypertension Research Center, Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA

[v ]Schulich Heart Program, Sunnybrook Health Sciences Centre and Department of Medicine, University of Toronto, Toronto, Canada

[w ]Department of Medicine, Turku University Hospital and University of Turku

[x ]Finnish Institute for Health and Welfare, Helsinki, Finland

[y ]The Conway Institute, University College Dublin, Dublin, Ireland

[z ]Experimental Cardiology, Department of Tropical Medicine Institute, Universidad Central de Venezuela, Venezuela

[aa ]Clinical Research Unit, Italian Institute of Telemedicine, Varese, Italy

[ab ]Department of Cardiology, Sechenov First Moscow State Medical University, Moscow, Russian Federation

[ac ]Department of Medical Sciences, University of Edinburgh, Edinburgh, UK

[ad ]Studium Patavinum, Department of Medicine. University of Padova, Padua

[ae ]Cardiovascular Department, ASST Papa Giovanni XXIII, Bergamo, Italy

[af ]Hypertension Unit, European Georges Pompidou Hospital, Paris, France

[ag ]Arterial Hypertension and Metabolic Unit, University Hospital, Fundacion Favaloro, Argentina

[ah ]Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart, Australia

[ai ]Department of Women and Children's Health, School of Life Course Sciences, FoLSM, Kings College London, UK

[aj ]Research Institute of Cardiovascular Diseases of the University of Zulia, Venezuelan Foundation of Arterial Hypertension. Maracaibo, Venezuela

[ak ]Diagnosis and Therapeutic Center, Paris-Descartes University, AP-HP, Hotel Dieu, Paris, France

[al ]Division of Cardiovascular Medicine, Downstate College of Medicine, State University of New York, Brooklyn, New York, USA

[am ]Department of Epidemiology, Tulane University, School of Public Health and Tropical Medicine, New Orleans, Lousiana

[an ]Cardiology Center, University of Connecticut School of Medicine, Farmington, Connecticut, USA

[ao ]University Milano-Bicocca, Milan, Italy

Author notes

Correspondence to Gianfranco Parati, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Department of Cardiovascular Neural and Metabolic Sciences, Milan, Italy. E-mail: gianfranco.parati@ 123456unimib.it , gianfrancoparati@ 123456gmail.com

Article

Publisher ID: JH-D-21-00524 Accession ID: 00003

DOI: 10.1097/HJH.0000000000002922

PMC ID: 9904446

PubMed ID: 34269334

SO-VID: c1def630-26c3-4c9e-b61c-286b18110985

License:

This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0

History

Date received : 18 May 2021

Date accepted : 23 May 2021

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Keywords: blood pressure measurement,cardiovascular disease,cardiovascular risk,home blood pressure monitoring,hypertension,prevention and control

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Keywords: blood pressure measurement, cardiovascular disease, cardiovascular risk, home blood pressure monitoring, hypertension, prevention and control

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

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Cardiovascular Innovations and Applications

Most cited references 292

2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary

Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents

2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC).

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