Many doctors encourage people with high blood pressure to check their blood pressure at home, but a new study suggests that most patients do not do it as often as recommended.
Even when people were given free blood pressure monitors, clear instructions, and ongoing support, many still struggled to keep up with regular testing.
The findings highlight a major challenge in helping people manage high blood pressure over the long term.
The study was carried out by researchers at Mass General Brigham and was published in JAMA Cardiology.
High blood pressure, also called hypertension, affects millions of people worldwide and is one of the leading causes of heart attacks, strokes, kidney disease, and heart failure. Because it usually causes no symptoms, many people do not realise their blood pressure is too high until serious health problems develop.
Doctors recommend home blood pressure monitoring because readings taken at home often provide a better picture of a person’s usual blood pressure than measurements taken during a clinic visit.
Stress, anxiety, or rushing to an appointment can temporarily raise blood pressure, making a single reading less reliable. Regular home measurements help doctors decide whether treatment is working or needs to be adjusted.
The American Heart Association recommends that people with high blood pressure take two readings, one minute apart, twice a day for several days before seeing their doctor. Following this schedule can provide a much clearer picture of blood pressure patterns over time.
To see how well people followed these recommendations, the researchers studied 3,390 participants who joined a remote blood pressure monitoring program between 2018 and 2022. Everyone received a free blood pressure monitor and instructions on how to use it. Their readings were automatically sent to healthcare workers through the monitoring system.
The results showed that people who regularly checked their blood pressure and stayed involved in the program achieved much better blood pressure control. They also had a 40% lower risk of serious health problems, including heart attacks and death. However, many participants never gained these benefits because they did not use the monitors consistently.
Almost one-third of the participants never used the monitor even once. Only about one-third completed nearly all of the recommended readings, while the rest checked their blood pressure only occasionally. This suggests that many people found the recommended schedule difficult to follow in everyday life.
The researchers believe the problem is not simply a lack of motivation. Busy work schedules, family responsibilities, discomfort while using the cuff, or simply forgetting may all make regular monitoring difficult. They say current recommendations may not fit easily into many people’s daily routines.
One possible solution is wearable blood pressure monitors that can automatically record readings throughout the day without requiring people to stop what they are doing.
Similar technology is already widely used by many people with diabetes to continuously monitor blood sugar levels. Researchers hope future wearable devices could make blood pressure monitoring much easier and improve long-term health.
The researchers say the study shows that providing equipment alone is not enough to change behaviour.
Future blood pressure programs may need simpler technology and easier routines to help more people stay engaged. Improving home monitoring could help doctors detect problems earlier and reduce the risk of heart disease, stroke, and other serious complications.
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