Home blood pressure monitoring: methodology, clinical relevance and practical application: a 2021 position paper by the Working Group on Blood Pressure Monitoring and Cardiovascular Variability of the European Society of Hypertension

Gianfranco Parati^{1

2}, George S Stergiou³, Grzegorz Bilo^{1

2}, Anastasios Kollias³, Martino Pengo¹, Juan Eugenio Ochoa¹, Rajiv Agarwal⁴, Kei Asayama^{5

6

7}, Roland Asmar⁸, Michel Burnier⁹, Alejandro De La Sierra¹⁰, Cristina Giannattasio^{2

11}, Philippe Gosse¹², Geoffrey Head¹³, Satoshi Hoshide¹⁴, Yutaka Imai⁷, Kazuomi Kario¹⁴, Yan Li¹⁵, Efstathios Manios¹⁶, Jonathan Mant¹⁷, Richard J McManus¹⁸, Thomas Mengden¹⁹, Anastasia S Mihailidou²⁰, Paul Muntner²¹, Martin Myers²², Teemu Niiranen^{23

24}, Angeliki Ntineri³, Eoin O'Brien²⁵, José Andres Octavio²⁶, Takayoshi Ohkubo^{5

7}, Stefano Omboni^{27

28}, Paul Padfield²⁹, Paolo Palatini³⁰, Dario Pellegrini³¹, Nicolas Postel-Vinay³², Agustin J Ramirez³³, James E Sharman³⁴, Andrew Shennan³⁵, Egle Silva³⁶, Jirar Topouchian³⁷, Camilla Torlasco¹, Ji Guang Wang¹⁵, Michael A Weber³⁸, Paul K Whelton³⁹, William B White⁴⁰, Giuseppe Mancia⁴¹; Working Group on Blood Pressure Monitoring and Cardiovascular Variability of the European Society of Hypertension

Affiliations

¹ Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Department of Cardiovascular Neural and Metabolic Sciences.
² Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
³ Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Athens, Greece.
⁴ Division of Nephrology, Department of Medicine, Indiana University School of Medicine and Richard L. Roudebush Veterans Administration Medical Center, Indianapolis, Indiana, USA.
⁵ Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.
⁶ Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.
⁷ Tohoku Institute for the Management of Blood Pressure, Sendai, Japan.
⁸ Foundation-Medical Research Institutes, Geneva.
⁹ Service of Nephrology and Hypertension, University Hospital, Lausanne, Switzerland.
¹⁰ Hypertension Unit, Department of Internal Medicine, Hospital Mútua Terrassa, University of Barcelona, Barcelona, Spain.
¹¹ Cardiology IV, 'A. De Gasperis" Department, ASTT GOM Niguarda Ca' Granda.
¹² Cardiology/Hypertension Unit Saint André Hospital. University Hospital of Borfeaux, France.
¹³ Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.
¹⁴ Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
¹⁵ Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
¹⁶ Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Alexandra Hospital, Athens, Greece.
¹⁷ Primary Care Unit, Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK.
¹⁸ Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
¹⁹ Kerckhoff Clinic, Rehabilitation, ESH Excellence Centre, Bad Nauheim, Germany.
²⁰ Department of Cardiology and Kolling Institute, Royal North Shore Hospital, St Leonards Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.
²¹ Hypertension Research Center, Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA.
²² Schulich Heart Program, Sunnybrook Health Sciences Centre and Department of Medicine, University of Toronto, Toronto, Canada.
²³ Department of Medicine, Turku University Hospital and University of Turku.
²⁴ Finnish Institute for Health and Welfare, Helsinki, Finland.
²⁵ The Conway Institute, University College Dublin, Dublin, Ireland.
²⁶ Experimental Cardiology, Department of Tropical Medicine Institute, Universidad Central de Venezuela, Venezuela.
²⁷ Clinical Research Unit, Italian Institute of Telemedicine, Varese, Italy.
²⁸ Department of Cardiology, Sechenov First Moscow State Medical University, Moscow, Russian Federation.
²⁹ Department of Medical Sciences, University of Edinburgh, Edinburgh, UK.
³⁰ Studium Patavinum, Department of Medicine. University of Padova, Padua.
³¹ Cardiovascular Department, ASST Papa Giovanni XXIII, Bergamo, Italy.
³² Hypertension Unit, European Georges Pompidou Hospital, Paris, France.
³³ Arterial Hypertension and Metabolic Unit, University Hospital, Fundacion Favaloro, Argentina.
³⁴ Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart, Australia.
³⁵ Department of Women and Children's Health, School of Life Course Sciences, FoLSM, Kings College London, UK.
³⁶ Research Institute of Cardiovascular Diseases of the University of Zulia, Venezuelan Foundation of Arterial Hypertension. Maracaibo, Venezuela.
³⁷ Diagnosis and Therapeutic Center, Paris-Descartes University, AP-HP, Hotel Dieu, Paris, France.
³⁸ Division of Cardiovascular Medicine, Downstate College of Medicine, State University of New York, Brooklyn, New York, USA.
³⁹ Department of Epidemiology, Tulane University, School of Public Health and Tropical Medicine, New Orleans, Lousiana.
⁴⁰ Cardiology Center, University of Connecticut School of Medicine, Farmington, Connecticut, USA.
⁴¹ University Milano-Bicocca, Milan, Italy.

PMID: 34269334
PMCID: PMC9904446
DOI: 10.1097/HJH.0000000000002922

Home blood pressure monitoring: methodology, clinical relevance and practical application: a 2021 position paper by the Working Group on Blood Pressure Monitoring and Cardiovascular Variability of the European Society of Hypertension

Gianfranco Parati et al. J Hypertens. 2021.

. 2021 Sep 1;39(9):1742-1767.

doi: 10.1097/HJH.0000000000002922.

Authors

Affiliations

¹ Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Department of Cardiovascular Neural and Metabolic Sciences.
² Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
³ Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Athens, Greece.
⁴ Division of Nephrology, Department of Medicine, Indiana University School of Medicine and Richard L. Roudebush Veterans Administration Medical Center, Indianapolis, Indiana, USA.
⁵ Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.
⁶ Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.
⁷ Tohoku Institute for the Management of Blood Pressure, Sendai, Japan.
⁸ Foundation-Medical Research Institutes, Geneva.
⁹ Service of Nephrology and Hypertension, University Hospital, Lausanne, Switzerland.
¹⁰ Hypertension Unit, Department of Internal Medicine, Hospital Mútua Terrassa, University of Barcelona, Barcelona, Spain.
¹¹ Cardiology IV, 'A. De Gasperis" Department, ASTT GOM Niguarda Ca' Granda.
¹² Cardiology/Hypertension Unit Saint André Hospital. University Hospital of Borfeaux, France.
¹³ Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.
¹⁴ Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
¹⁵ Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
¹⁶ Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Alexandra Hospital, Athens, Greece.
¹⁷ Primary Care Unit, Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK.
¹⁸ Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
¹⁹ Kerckhoff Clinic, Rehabilitation, ESH Excellence Centre, Bad Nauheim, Germany.
²⁰ Department of Cardiology and Kolling Institute, Royal North Shore Hospital, St Leonards Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.
²¹ Hypertension Research Center, Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA.
²² Schulich Heart Program, Sunnybrook Health Sciences Centre and Department of Medicine, University of Toronto, Toronto, Canada.
²³ Department of Medicine, Turku University Hospital and University of Turku.
²⁴ Finnish Institute for Health and Welfare, Helsinki, Finland.
²⁵ The Conway Institute, University College Dublin, Dublin, Ireland.
²⁶ Experimental Cardiology, Department of Tropical Medicine Institute, Universidad Central de Venezuela, Venezuela.
²⁷ Clinical Research Unit, Italian Institute of Telemedicine, Varese, Italy.
²⁸ Department of Cardiology, Sechenov First Moscow State Medical University, Moscow, Russian Federation.
²⁹ Department of Medical Sciences, University of Edinburgh, Edinburgh, UK.
³⁰ Studium Patavinum, Department of Medicine. University of Padova, Padua.
³¹ Cardiovascular Department, ASST Papa Giovanni XXIII, Bergamo, Italy.
³² Hypertension Unit, European Georges Pompidou Hospital, Paris, France.
³³ Arterial Hypertension and Metabolic Unit, University Hospital, Fundacion Favaloro, Argentina.
³⁴ Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart, Australia.
³⁵ Department of Women and Children's Health, School of Life Course Sciences, FoLSM, Kings College London, UK.
³⁶ Research Institute of Cardiovascular Diseases of the University of Zulia, Venezuelan Foundation of Arterial Hypertension. Maracaibo, Venezuela.
³⁷ Diagnosis and Therapeutic Center, Paris-Descartes University, AP-HP, Hotel Dieu, Paris, France.
³⁸ Division of Cardiovascular Medicine, Downstate College of Medicine, State University of New York, Brooklyn, New York, USA.
³⁹ Department of Epidemiology, Tulane University, School of Public Health and Tropical Medicine, New Orleans, Lousiana.
⁴⁰ Cardiology Center, University of Connecticut School of Medicine, Farmington, Connecticut, USA.
⁴¹ University Milano-Bicocca, Milan, Italy.

PMID: 34269334
PMCID: PMC9904446
DOI: 10.1097/HJH.0000000000002922

Abstract

The present paper provides an update of previous recommendations on Home Blood Pressure Monitoring from the European Society of Hypertension (ESH) Working Group on Blood Pressure Monitoring and Cardiovascular Variability sequentially published in years 2000, 2008 and 2010. This update has taken into account new evidence in this field, including a recent statement by the American Heart association, as well as technological developments, which have occurred over the past 20 years. The present document has been developed by the same ESH Working Group with inputs from an international team of experts, and has been endorsed by the ESH.

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Conflict of interest statement

R.A. has received honoraria from Akebia, AstraZeneca, Bayer, Boehringer Ingelheim, Chinook, Diamedica, Merck, Reata, Relypsa and Sanofi, and has received royalties from UpToDate. R.A. is supported by National Heart Lung and Blood Institute grant R01 HL126903 and U.S. Veterans Administration grant I01CX001753. K.A. has received Research support from Omron Healthcare.

P.G. has received Research grants from Recor Medical. K.K. has received Research grants from Omron Healthcare Fukuda Denshi, and A&D, Otsuka Medical. Y.L. has received research grants from A&D, Bayer, Omron and lecture fees from A&D, Daiichi Sankyo, Omron and Takeda. J.M. is part of the Scientific Advisory Board for BMS/Pfizer. R.J.M., grant income from NIHR; telemonitoring development and evaluation with Omron (all fees to his institution); speaker expenses ESH 2019 and ASN 2019. Honoraria paid to his institution/College. A.S.M. has received research funding from Novartis & honorarium from Merck, Servier, Hillrom. T.O. has received research grant from Omron Healthcare Co.Ltd. S.O. is a scientific consultant of Biotechmed Ltd. provider of telemedicine services. G.P. has received honoraria for lectures by OMRON Healthcare, SERVIER, Sanofi, FIDIA.

P.P. has received honoraria for validation Studies from MIcrolife, AND, and Hingmed. G.S. has conducted validation studies for various manufacturers of blood pressure measurement technologies and advised manufacturers on device and software development. J.-G.W. has received grants from Omron. M.A.W. is a consultant for Medtronic; ReCor; Ablative Solutions; Urovant; Regeneron; Bayer.

W.B.W. is a cardiovascular safety consultant (DSMB, CV endpoints committees) for Astra-Zeneca, Bristol-Myers Squibb, Takeda-Millenium; and editor for UptoDate (Wolters Kluwer).

References

1. Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. List of authors/Task Force members. 2018 Practice guidelines for the management of arterial hypertension of the European Society of Hypertension and the European Society of Cardiology: ESH/ESC Task Force for the Management of Arterial Hypertension. J Hypertens 2018; 36:2284–2309. - PubMed
1. Whelton PK, Carey RM, Aronow WS, Casey DE, Jr, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension 2018; 71:1269–1324. - PubMed
1. Asmar R, Zanchetti A. Guidelines for the use of self-blood pressure monitoring: a summary report of the First International Consensus Conference. Groupe Evaluation & Measure of the French Society of Hypertension. J Hypertens 2000; 18:493–508. - PubMed
1. Parati G, Stergiou GS, Asmar R, Bilo G, de Leeuw P, Imai Y, et al. ESH Working Group on Blood Pressure Monitoring. European Society of Hypertension guidelines for blood pressure monitoring at home: a summary report of the Second International Consensus Conference on Home Blood Pressure Monitoring. J Hypertens 2008; 26:1505–1526. - PubMed
1. Parati G, Stergiou GS, Asmar R, Bilo G, de Leeuw P, Imai Y, et al. ESH Working Group on Blood Pressure Monitoring. European Society of Hypertension practice guidelines for home blood pressure monitoring. J Hum Hypertens 2010; 24:779–785. - PubMed

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Home blood pressure monitoring: methodology, clinical relevance and practical application: a 2021 position paper by the Working Group on Blood Pressure Monitoring and Cardiovascular Variability of the European Society of Hypertension

Affiliations

Home blood pressure monitoring: methodology, clinical relevance and practical application: a 2021 position paper by the Working Group on Blood Pressure Monitoring and Cardiovascular Variability of the European Society of Hypertension

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous