Usefulness of Home Blood Pressure in the Diagnosis and Control of Hypertension in Primary Care

Self- measurement of blood pressure (BP) at home has gained increasing importance for the diagnostic and therapeutic evaluation of hypertensive patients. In comparison with clinic BP, self-measurement of BP with automated devices has several advantages: (1) higher reproducibility; (2) elimination of the "white coat effect" and observer bias; and (3) improvement of both compliance and BP control. Furthermore, there is evidence that home BP better correlates with target-organ damage and prognosis and provides a more accurate evaluation of treatment effect. On the other hand, it has great potential advantages of lower equipment and staff cost compared with ambulatory BP. These features of home BP have led various medical organizations to recognize its clinical usefulness in the diagnosis of white coat hypertension and in evaluating response to antihypertensive medication, particularly in the primary care setting. We aim here to present a critical review of the uses, strengths and weaknesses of the technique of home BP monitoring for the assessment of hypertension in the clinical practice.