Recommendation ID

Which automated blood pressure monitors are suitable for people with hypertension and atrial fibrillation?

Any explanatory notes
(if applicable)

Why the committee made the recommendations

The committee agreed that there was not enough evidence to strongly recommend HBPM for monitoring treatment in adults with hypertension. The evidence on monitoring was limited, with relatively small studies comparing different combinations of HBPM (with or without telemonitoring and with or without pharmacist input), pharmacy monitoring and clinic monitoring. It suggested that people had improved blood pressure control with HBPM with telemonitoring, with or without pharmacy input, compared with clinic monitoring, and the greatest blood pressure reduction was achieved with pharmacist input. However, the evidence was insufficient for the committee to make a recommendation.

The committee decided to retain the 2011 recommendation on using clinic blood pressure, but also agreed that the updated guideline should support home monitoring for people who wish to use it. The committee discussed the importance of patient choice and agreed that home monitoring should be an option, if it is suitable and the person is willing and motivated to use it. HBPM is already widely used in practice, especially for people with a white-coat effect. The committee agreed this would be reflected in the recommendation supported by the evidence and consensus opinion. Based on their experience, the committee agreed that training and advice would be needed for people using HBPM to ensure that people take measurements correctly and know when to contact their healthcare professional if they are not achieving their target blood pressure.

The 2011 guideline included a recommendation for further research for the best method of monitoring hypertension in people with atrial fibrillation. No evidence was identified in the updated reviews to inform recommendations for this group and therefore the committee agreed that this research recommendation should be retained to inform future updates of the guideline .

The committee agreed they could not make a recommendation on telemonitoring because the evidence was not sufficient to show a clear benefit and the studies were inconsistent in the telemonitoring methods used.

Source guidance details

Comes from guidance
Hypertension in adults: diagnosis and management
Date issued
August 2019

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No  
Last Reviewed 31/08/2019