Self-Monitoring Blood Pressure After Stroke: Key Findings from a Clinical Trial
Background
Controlling blood pressure (BP) after a stroke is very important, but many patients are not getting the care they need. This trial looked at whether self-monitoring of blood pressure, combined with support from healthcare providers, can help reduce BP more effectively than regular care for patients who have had a stroke or a transient ischemic attack (TIA).
Methods
This was a randomized controlled trial conducted in 12 primary care practices in England. Patients who had a stroke or TIA and had a clinic BP between 130-180 mmHg were invited to participate. They were randomly assigned to either the self-monitoring group or the usual care group. The self-monitoring intervention allowed patients to track their BP at home and receive feedback on their medication adjustments. The main goal was to see how BP changed after 12 months, but the study ended early due to funding issues during the COVID-19 pandemic.
Results
Out of 650 invitations sent, 129 responded. Only 55 patients were randomized before the pandemic. Before the trial, the average BP was similar in both groups. After the trial started, the average BP improved slightly in both groups, with those in the self-monitoring group showing a better reduction. Most participants in the self-monitoring group used the intervention for at least 7 months.
Conclusions
Recruiting participants with a history of stroke or TIA for this trial was successful before the pandemic. Most participants in the self-monitoring group actively engaged with the program. Both groups showed some improvement in BP control. Digital health tools like self-monitoring are practical for patients with stroke/TIA and should be evaluated in future studies.
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