Abstract: FR-OR037
Self-Monitoring and Self-Management of Hypertension in US Veterans: A Randomized Controlled Trial
Session Information
- Hypertension and Cardiorenal Disease: Novel Mechanisms and Therapeutic Targets
November 07, 2025 | Location: Room 332A, Convention Center
Abstract Time: 04:30 PM - 04:40 PM
Category: Hypertension and CVD
- 1602 Hypertension and CVD: Clinical
Authors
- Rifkin, Dena E., VA San Diego Healthcare System, San Diego, California, United States
- Potok, O. Alison, VA San Diego Healthcare System, San Diego, California, United States
- Rifkin, Scott A., University of California San Diego, La Jolla, California, United States
- Shlipak, Michael, University of California San Francisco, San Francisco, California, United States
- Ix, Joachim H., VA San Diego Healthcare System, San Diego, California, United States
Background
Self-monitoring and self-titration of antihypertensive medication has been tested in non-US settings and found to be effective and safe but has not been translated to US settings.We tested a standardized self-management plan (SM) for antihypertensive medication self-titration compared to usual care (UC) for patients with hypertension.
Methods
Unblinded RCT involving 119 hypertensive participants with baseline systolic blood pressure (SBP) of >130 mm Hg on no more than 2 medications at 2 VA medical centers.The intervention was SM according to a protocol which included high/low alert values, plus standardized BP medication changes with a target home BP of <120/80 mm Hg over 12 months.UC participants received a home BP cuff and were encouraged to share readings with their PCP.The12-month BP difference between groups was the primary outcome; safety and acceptability were secondary outcomes.
Results
At baseline, the mean SBP and DBP in the SM group were 136.0/80.5 mm Hg, and i140.3/78.7 mmHg in UC. After 12 months, the BP decreased to 129.9/76.3 mm Hg in SM (reduction 6.1 mm Hg in SBP, p< 0.01), and 137.0/77.6 mm Hg in UC (reduction 3.3 mm Hg, p =0.17). The between-group SBP change at the end of study was non-significantly lower with SM (1.9 mm Hg, p = 0.55 between SM and UC) and results were similar in subgroups (Figure). There were no excess adverse events in the SM group (one possibly related hospitalization in each group, and one death in the SM group prior to initiation of SM). 80% of participants rated themselves as likely to continue such a program if offered.
Conclusion
An SM BP protocol resulted in similar blood pressure reduction as UC. SM was safe and well accepted by participants and should be considered in US clinical practice.
Blood pressure differences in full study and subgroups
Funding
- Veterans Affairs Support