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Effect of home monitoring of blood pressure on control of hypertension.

Introduction

Hypertension is a medical dilemma that can affect an individual's health due to complications and involvement of multi body systems. Home monitoring blood pressure is an opportunity for patients with hypertension to control their own blood pressure and health status, and thus preventing potentially serious complications. This study was conducted to assess the effect of home monitoring of blood pressure on control of hypertension

Methodology

A cross sectional study was conducted on a sample of 406 hypertensive patients who were followed up at the chronic disease clinics of primary health care centers. The sample size taken had been proportionate to the total number of registered cases of hypertension in each center. A questionnaire was designed and data was collected by direct interview and review of medical records.

Results

Out of a total of 406 hypertensive patients, 38.4% practiced home blood pressure monitoring (HMBP). Most were in the age group 40-60 years with a total of 50.0 %. 58.1% of hypertensive patients who were illiterate. The majority of them were housewives represented 33.7% while employees represented 23.9%. HMBP was 100% for age group < 30 years and 73.1% among age group 30-40 years and decreased gradually to reach 23.1%. The highest percentage of use of HMBP was among patients of < 5 years duration of hypertension and those with a duration of 10 -15 years (45.8% and 39.4%, respectively) and 70.5% followed up at chronic disease clinic, 88.2% had regular follow up. The majority (93.6% ) of patients were on anti-hypertension medications and 6.4 % were under dietary control with practiced physical activity. Majority (71.5%) of hypertensive patients who practiced HMBP presented with blood pressure at normal level. 3.8% had admitted to the hospital due to hypertension complications. Diabetes mellitus was the commonest chronic disease in 56.5%. The reported complications were hyperlipidemia (30.8%), recurrent chest pain (11.8%), myocardial ischemia (9.9%) and proteinuria (8.1%). Weakness was commonly reported (40.9 %), followed by dizziness (39.2 %), chronic headaches (34.5 %), blurred vision (21.7 % ) then rapid heartbeat (17.2 %), tinnitus (14.0 %), while easy fatigability was reported by (12. 3 %).Most of them use electronic type (71.2%) and 33.3% of them used it according to a relatives' advice. The duration of using HMBP in the majority of patients was less than 40 months as reported by 73.1% of users. It was found that 54.5 % were monitoring blood pressure irregularly. Only 26.3% were practicing HMBP regularly and on daily bases. Only 22.4 % of patients recorded their blood pressure level after they read it from the monitor, cards for recording the level of blood pressure were available with 17.9 %. 46.8% received teaching/training on how to practice HMBP. Patients who said, HMBP helps in maintaining blood pressure levels within normal (65.4%).

Conclusion

Blood pressure monitoring at home; helps the hypertensive patients to maintain their blood pressure at normal level, therefore modify and prevent the onset of hypertension complications.