It is an already assessed element the fact that half patients under treatment for hypertension do not present acceptable pressure values, so, researchers have wondered: if self-control for asthma or for coagulation is a consolidated and effective practice, can it become so in the case of hypertension, too? Some English researchers have randomized 480 adults with non-controlled hypertension (>140/90 in spite of the treatment with one or two drugs) to the usual therapies or to self-control: patients in the self-control group have measured pressure with automatic sphygmomanometers twice in the morning, for a week in a month. The ones presenting values averagely higher than the expected target (130/85 in non-diabetics, 130/75 in diabetics) for two consecutive months had to contact their general practitioner to obtain a change in their therapy. Pressure has been then measured by physicians every 6 months and compliance to protocol has been controlled in telemonitoring by general practitioners. The average pressure at the beginning of the trial was 152/85 mmHg in both groups. After 6 months, the average in the group of the traditional therapy and in the self-control one were respectively 143/80 mmHg and 139/80 mmHg; after 12 months they were respectively 140/80 mmHg and 135/77 mmHg. The differences between the groups, both for systolic and for diastolic pressure, are statistically significant. The adding of anti-hypertensive drugs has been more frequent in the self-control group.
There are some points to be cleared up: we do not know which is the social-cultural level of the participants to the trial, we do not know the reliability of electronic pressure meters and we do not know the costs/benefits relation of such an intervention. For the moment, it seems premature to entrust the management of hypertension to the patient himself.
