Prognostic significance of self-measurements of blood pressure

Background. Self-measurements of blood pressure may offer some advantage in diagnostic and therapeutic evaluation and in management of patients. However, the most important limitation of self-measurement is that there are limited data available about the prognostic value of this information. Results. Authors of several previous reports demonstrated that self-measurement reflects target-organ damage better than does casual measurement of blood pressure. So far, investigators in Tecumseh and Ohasama studies have provided pilot data on prognostic value of self-measurements. Investigators in Ohasama study demonstrated that self-measurements predict cardiovascular morbidity and mortality and all-cause mortality better than do casual measurements of blood pressure. Investigators in Tecumseh study demonstrated that self-measurement can predict future development of sustained hypertension and of diastolic dysfunction. These preliminary results suggest that self-measurements have strong predictive power for endpoints and surrogate measures of cardiovascular target-organ damage. Conclusion. The final answer on the prognostic significance of self-measurement has not been given. Prognostic studies designed to compare casual measurement of blood pressure, self-measurement, and ambulatory blood pressure monitoring are needed. (C) 2000 Lippincott Williams and Wilkins.