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Meta-Analysis
. 2025 Feb;48(2):574-591.
doi: 10.1038/s41440-024-01981-4. Epub 2024 Nov 21.

Self-measurement of blood pressure at home using a cuff device for change in blood pressure levels: systematic review and meta-analysis

Michihiro Satoh  1   2   3 , Yukako Tatsumi  4 , Shingo Nakayama  5 , Yukiko Shinohara  6 , Miki Kawazoe  6 , Yoichi Nozato  7 , Ayako Kunimura  8 , Takahisa Murakami  9   10 , Maya Toyama  9   10 , Tomoko Muroya  9   11 , Takahito Yagihashi  9 , Atsushi Sakima  12 , Makiko Abe  6 , Hisatomi Arima  6 , Takayoshi Ohkubo  4
Affiliations
Meta-Analysis

Self-measurement of blood pressure at home using a cuff device for change in blood pressure levels: systematic review and meta-analysis

Michihiro Satoh et al. Hypertens Res. 2025 Feb.

Abstract

The effect of self-measurement of blood pressure (BP) at home (home BP measurement, HBPM) has been evaluated over the past decade. This meta-analysis included the latest studies to determine whether HBPM reduced BP (PROSPERO ID: CRD42023442225). PubMed, Cochrane Library Database, and IchuShi-Web were searched for randomized controlled trials after the year 2000 which demonstrated the effect of HBPM on BP change compared with usual care (UC). Overall, 65 articles (n = 21,053; 63 based on patients with hypertension) were included. The systolic/diastolic BP reduction was significantly greater in the HBPM than in the UC group by 3.27/1.61 mmHg (95% confidence intervals: 2.40-4.15/1.14-2.07) at the end of the intervention, and I2 values ≥ 46.7% suggested moderate-to-high heterogeneity. The funnel plots exhibited no notable publication bias (Egger's test p ≥ 0.16). HBPM with co-interventions (such as telemonitoring) showed a stronger BP-lowering effect than without co-interventions while the effect of HBPM on BP change remained significant in the absence of co-interventions. HBPM was not associated with systolic BP changes when we combined the four studies that used a wrist cuff device for HBPM. The number of antihypertensive medications increased by 0.17 medications in the HBPM group compared with that in the UC group. There were no significant differences in body mass index changes or risk of severe adverse outcomes between the groups. Our results demonstrated a beneficial effect of HBPM in reducing BP, particularly when used in conjunction with telemonitoring or additional medical support and when employing upper-arm cuff devices.

Keywords: Ambulatory; Blood pressure monitoring; Meta-analysis; Randomized controlled trial; Systematic review; Telemedicine.

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Conflict of interest statement

Compliance with ethical standards. Conflict of interest: TO received honoraria (lecture fee) and a joint research grant from Omron Healthcare Co., Ltd.

Figures

Fig. 1
Fig. 1
Overall results for the differences in the systolic blood pressure (SBP) change. N indicates the final number of participants used for analysis in each study. CI confidence interval, BPM blood pressure measurement method to obtain the outcome value, OBP office blood pressure, ABP ambulatory blood pressure, HBPM home blood pressure measurement, UC usual care
Fig. 2
Fig. 2
Overall results for the difference in the diastolic blood pressure (DBP) change. N indicates the final number of participants used for analysis in each study. CI confidence interval, BPM blood pressure measurement method to obtain the outcome value, OBP office blood pressure, ABP ambulatory blood pressure, HBPM home blood pressure measurement, UC usual care
Fig. 3
Fig. 3
Differences in the systolic blood pressure (SBP) change stratified by co-interventions. Co-intervention indicates support through telemonitoring, co-medical staff, or other methods including reminders via telephone or text message. CI confidence interval, BPM blood pressure measurement method to obtain the outcome value, OBP office blood pressure, ABP ambulatory blood pressure, HBPM home blood pressure measurement, UC usual care
Fig. 4
Fig. 4
Differences in the diastolic blood pressure (DBP) change stratified by co-interventions. Co-intervention indicates support through telemonitoring, co-medical staff, or other methods including reminders via telephone or text message. CI confidence interval, BPM blood pressure measurement method to obtain the outcome value, OBP office blood pressure, ABP ambulatory blood pressure, HBPM home blood pressure measurement, UC usual care
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