Does home blood pressure monitoring improve blood pressure-related outcomes in people living with chronic kidney disease? A systematic review

Nathan P Carey; Ffion Curtis; McKenna L Eisenbeisz; Sadaf Akbari; Meenakshi Sambharia; Diana I Jalal; Thomas J Wilkinson

doi:10.1111/jch.14795

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Does home blood pressure monitoring improve blood pressure-related outcomes in people living with chronic kidney disease? A systematic review

Journal article

Open access

Peer reviewed

Does home blood pressure monitoring improve blood pressure-related outcomes in people living with chronic kidney disease? A systematic review

Nathan P Carey, Ffion Curtis, McKenna L Eisenbeisz, Sadaf Akbari, Meenakshi Sambharia, Diana I Jalal and Thomas J Wilkinson

The journal of clinical hypertension (Greenwich, Conn.), Vol.26(4), pp.314-329

04/2024

DOI: 10.1111/jch.14795

PMCID: PMC11007799

PMID: 38523586

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Abstract

High blood pressure is an important risk factor for cardiovascular disease and disease progression in chronic kidney disease (CKD). Evidence on the effects of home blood pressure monitoring (HBPM) is limited. This review aimed to determine the effect of HBPM on systolic (SBP) and diastolic blood pressure (DBP) in patients with CKD. We searched medical literature databases for eligible studies presenting pre- and post-data for interventions utilizing HBPM. Study quality was assessed using the NHLBI tools for quality assessment. Heterogeneity prohibited a meta-analysis so estimates of effects were calculated along a sign test to examine the probability of observing the given pattern of positive effect direction. Eighteen studies were included (n = 1187 participants, mean age 56.7 [± 7.7] years). In 15 studies, HBPM was conducted within the context of additional high-level tailored support. Overall, the quality of n = 7/18 studies was rated as "good"; n = 6/18 were "fair," and n = 5/18 were rated as "poor." Interventions utilizing HBPM had a significant effect on SBP, with 14/16 studies favoring the intervention (88% [95% CI: 62%-98%], P = .002). Favorable effects were also seen on DBP (73% [95% CI: 45%-92%], P = .059). HBPM had a favorable effect on blood pressure goal attainment (86% [95% CI: 42%-100%], P = .062). HBPM in patients with CKD as part of a multicomponent intervention may lead to clinically significant reductions in blood pressure; however, research is needed to support the validity of this claim due to the high heterogeneity across the studies included.

Kidney Diseases

Hypertension

blood pressure

risk factors

renal insufficiency

kidney failure

cardiovascular diseases

chronic

Details

Title: Subtitle: Does home blood pressure monitoring improve blood pressure-related outcomes in people living with chronic kidney disease? A systematic review
Creators: Nathan P Carey - NIHR Applied Research Collaboration East Midlands, Leicester, UK
Ffion Curtis - University of Liverpool
McKenna L Eisenbeisz - Center for Access & Delivery Research and Evaluation (CADRE), Iowa City VA HCS, Iowa City, Iowa, USA
Sadaf Akbari - Center for Access & Delivery Research and Evaluation (CADRE), Iowa City VA HCS, Iowa City, Iowa, USA
Meenakshi Sambharia - Center for Access & Delivery Research and Evaluation (CADRE), Iowa City VA HCS, Iowa City, Iowa, USA
Diana I Jalal - Center for Access & Delivery Research and Evaluation (CADRE), Iowa City VA HCS, Iowa City, Iowa, USA
Thomas J Wilkinson - NIHR Leicester Biomedical Research Centre
Resource Type: Journal article
Publication Details: The journal of clinical hypertension (Greenwich, Conn.), Vol.26(4), pp.314-329
DOI: 10.1111/jch.14795
PMID: 38523586
PMCID: PMC11007799
NLM abbreviation: J Clin Hypertens (Greenwich)
eISSN: 1751-7176
Language: English
Electronic publication date: 03/25/2024
Date published: 04/2024
Academic Unit: Surgery; Nephrology; Internal Medicine
Record Identifier: 9984577054402771

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