The clinical meaning of home blood pressure monitoring and its application to daily clinical practice

摘要

Seven million home blood pressure (HBP) monitors are manufactured annually and a total of more than 30 million monitors have been sold in Japan. HBP monitoring is regarded as clinically useful according to various overseas guidelines. The criteria for the diagnosis of hypertension based on HBP monitoring are specified by the Japanese Society of Hypertension (JSH) because of its excellent prognostic value, and it was also assessed as clinically useful in the 2004 JSH hypertension treatment guidelines (JSH 2004) released last autumn. Thus, HBP monitoring is becoming increasingly important. HBP monitoring boosts a patient's awareness of the treatment of hypertension, leading to better compliance with drug intake and overall treatment. In addition, it is very useful for assessing the therapeutic effect and duration of action of drugs. HBP morning is also required for the diagnosis of morning hypertension as well as white coat hypertension and reverse white coat hypertension. The HBP monitors released in recent years can even measure blood pressure during sleep. The JSH 2004 regarding HBP monitoring was based on "The 2003 Guidelines for HBP Monitoring". As mentioned above, HBP monitoring is expected to contribute to improving the treatment of hypertension and medical economy. Both the blood pressure measured at a hospital and that measured at home are red blood pressures. It is impossible to determine a single specific blood pressure value for a patient, so it appears to be more rational to estimate the usual blood pressure from data obtained under various conditions. In this article, we review the clinical meaning of HBP monitoring based on the current situation and discuss problems with HBP monitoring and its application to daily clinical practice.