Blood pressure control by home monitoring: meta-analysis of randomised trials
http://www.100md.com
《英国医生杂志》
1 Department of Community Health Sciences, St George's Hospital Medical School, London SW17 0RE, 2 Bazian Ltd, London N1 1QP
Correspondence to: F P Cappuccio f.cappuccio@sghms.ac.uk
Abstract
High blood pressure is one of the most readily preventable causes of stroke and other cardiovascular complications.1-4 It can be easily detected, and most cases have no underlying detectable cause; the most effective way to reduce the associated risk is to reduce the blood pressure. Unlike many other common, chronic conditions, we have very effective ways of treating high blood pressure and we have clear evidence of the benefits of such interventions.1 However, despite a great deal of time and effort, hypertension is still underdiagnosed and undertreated.5 Furthermore, losses to follow up are high and are responsible for avoidable vascular deaths.6
Blood pressure is usually measured and monitored in the healthcare system by doctors or nurses in hospital outpatient departments and, increasingly, in primary care settings. New electronic devices have been introduced and validated in the clinical setting to replace the mercury sphygmomanometer and to overcome the large variations in measurement due to variability between observers. Ambulatory blood pressure monitoring is also being used more often to assess individuals' blood pressures outside the clinical setting.
Measuring blood pressure at home is becoming increasingly popular with both doctors and patients.7 8 Some national and international guidelines also recommend home monitoring in certain circumstances.9 A recent qualitative review of the role of home blood pressure measurement in managing hypertension concluded that no evidence exists as to whether home monitoring leads to better control of high blood pressure.10
We reviewed the literature on home blood pressure monitoring and did a meta-analysis of the effect of home monitoring on blood pressure levels and the control of hypertension in randomised trials that compared home or "self" blood pressure monitoring and usual blood pressure monitoring in the healthcare system.
Methods
We identified 18 randomised controlled trials that compared blood pressure control or the proportion of people with blood pressure above target. The table shows the characteristics of the analysed trials. Six were based in hospital outpatient clinics,14 19 21 22 25 31 eight in communities and general practices,16 18 23 24 26-29 and four in mixed settings.15 17 20 30 Treatment in the "control" group was mainly "usual" or "standard" care,15-19 21 22 24-29 31 but some trials had nurse clinics,14 30 educational interventions,20 or flagged medical records.23 Trials used different methods of home or self blood pressure monitoring. In total, 1359 people were randomised to home or self blood pressure monitoring and 1355 to a control group of blood pressure monitoring by health professionals in clinical settings. Two trials used a factorial design,16 18 four had more than two randomised groups,17 19 20 29 and one was randomised in clusters.23 Only in eight trials was outcome assessment stated to have been blind,14-16 24 25 29 31 and only in nine was randomisation concealed.15-18 20 21 24 29 31 The duration of the intervention varied between two months31 and 36 months.19
Characteristics of trials included in meta-analysis of home or self blood pressure monitoring
Systolic blood pressure
Thirteen studies reported systolic blood pressure at follow up and baseline or the change from baseline (see appendix D1 on bmj.com), but only five of these studies reported full data on means and the standard deviation of the difference. For the remaining seven studies we estimated standard deviations. The overall effect of intervention was 4.2 (95% confidence interval 1.5 to 6.9) mm Hg, with highly significant heterogeneity between studies (P < 0.001) (fig 2, top panel). The funnel plot showed some asymmetry, and Egger's test for publication bias was significant (P = 0.038) (fig 3, top panel). The trim and fill method estimated three missing studies and gave a revised estimate of 2.2 (-0.9 to 5.3) mm Hg.
Fig 2 Standardised mean differences (95% confidence interval) in systolic (top), diastolic (middle), and mean (bottom) blood pressures achieved in people monitoring blood pressure at home compared with people whose blood pressure was monitored by health professionals in clinical settings
Fig 3 Funnel plots for systolic and diastolic blood pressure
Diastolic blood pressure
Sixteen studies reported diastolic blood pressure at follow up and baseline or the change from baseline (see appendix D2 on bmj.com), but only eight of these studies reported full data on means and the standard deviation of the difference. For the remaining eight studies we estimated standard deviations. One study had multiple endpoints.19 We included results from the one year endpoint. Use of the two year endpoint did not make an important difference to the results (2.2 (1.0 to 3.3) mm Hg). The overall effect of intervention was 2.4 (1.2 to 3.5) mm Hg, with significant heterogeneity between studies (P = 0.014) (fig 2, middle panel). The funnel plot showed some asymmetry (fig 3, bottom panel) (Egger's test for publication bias, P = 0.095). The trim and fill method estimated two missing studies and gave a revised estimate of 1.9 (0.6 to 3.2) mm Hg.
Mean arterial pressure
Three studies reported mean arterial pressure, one of which did not report either systolic or diastolic blood pressure.25 All studies reported change from baseline (see appendix D3 on bmj.com) with standard deviation of the difference. The overall effect was 4.4 (2.0 to 6.8) mm Hg, with no significant heterogeneity (P = 0.319) (fig 2, bottom panel).
Blood pressure above target
Six studies reported the number of patients whose blood pressure was controlled at follow up. Different definitions of blood pressure control were used (see appendix C on bmj.com). Two studies reported the outcome at more than one time point. The analysis reported here is for the one year outcome in both studies. The overall relative risk was 0.90 (0.80 to 1.00), with no significant heterogeneity between studies (P = 0.34) (fig 4). Inclusion of the two year outcomes for Earp17 and Stahl19 slightly reduced the effect—relative risk 0.92 (0.83 to 1.04).
Fig 4 Standardised relative risk of blood pressure above target in people monitoring blood pressure at home compared with people whose blood pressure was monitored by health professionals in clinical settings
Discussion
Collins R, Peto R, MacMahon S, Hebert P, Fiebach NH, Eberlein KA, et al. Blood pressure, stroke and coronary heart disease. II. Short term reductions in blood pressure: overview of randomised drug trials in their epidemiological context. Lancet 1990;335: 827-38.
MacMahon S, Peto R, Cutler J, Collins R, Sorlie P, Neaton J, et al. Blood pressure, stroke and coronary heart disease. I. Effect of prolonged differences in blood pressure: evidence from nine prospective observational studies corrected for the regression dilution bias. Lancet 1990;335: 765-74.
Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002;360: 1903-13.
Prospective Studies Collaboration. Cholesterol, diastolic blood pressure, and stroke: 13,000 strokes in 450,000 people in 45 prospective cohorts. Lancet 1995;346: 1647-53.
Primatesta P, Brookes M, Poulter NR. Improved hypertension management and control: results from the health survey for England 1998. Hypertension 2001;38: 827-32.
Du X, Cruickshank K, McNamee R, Saraee M, Sourbutts J, Summers A, et al. Case-control study of stroke and the quality of hypertension control in north west England. BMJ 1997;314: 272-6.
Yarows SA, Staessen JA. How to use home blood pressure monitors in clinical practice. Am J Hypertens 2002;15: 93-6.
Yarows SA, Julius S, Pickering TG. Home blood pressure monitoring. Arch Intern Med 2000;160: 1251-7.
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA 2003;289: 2560-71.
Rickerby J. The role of home blood pressure measurement in managing hypertension: an evidence-based review. J Hum Hypertens 2002;16: 469-72.
Cartwright W, Dalton KJ, Swindells H, Rushant S, Mooney P. Objective measurement of anxiety in hypertensive pregnant women managed in hospital and in the community. Br J Obstet Gynaecol 1992;99: 182-5.
Glanz K, Kirscht JP, Rosenstock IM. Linking research and practice in patient education for hypertension: patient responses to four educational interventions. Med Care 1981;19: 141-52.
Ross-McGill H, Hewison J, Hirst J, Dowswell T, Holt A, Brunskill P, et al. Antenatal home blood pressure monitoring: a pilot randomised controlled trial. Br J Obstet Gynaecol 2000;107: 217-21.
Carnahan.JE, Nugent CA. The effects of self monitoring by patients on the control of hypertension. Am J Med Sci 1975;269: 69-73.
Haynes RB, Sackett DL, Gibson ES, Taylor DW, Hackett BC, Roberts RS, et al. Improvement of medication compliance in uncontrolled hypertension. Lancet 1976;i: 1265-8.
Johnson AL, Taylor DW, Sackett DL, Dunnett CW, Shimizu AG. Self-recording of blood pressure in the management of hypertension. CMAJ 1978;119: 1034-9.
Earp JA, Ory MG, Strogatz DS. The effects of family involvement and practitioner home visits on the control of hypertension. Am J Public Health 1982;72: 1146-54.
Pierce JP, Watson DS, Knights S, Gliddon T, Williams S, Watson R. A controlled trial of health education in the physician's office. Prev Med 1984;13: 185-94.
Stahl SM, Kelley CR, Neill PJ, Grim CE, Mamlin J. Effects of home blood pressure measurement on long-term BP control. Am J Public Health 1984;74: 704-9.
Binstock ML, Franklin KL. A comparison of compliance techniques on the control of high blood pressure. Am J Hypertens 1988;1: 192-4S.
Midanik LT, Resnick B, Hurley LB, Smith EJ, McCarthy M. Home blood pressure monitoring for mild hypertensives. Public Health Rep 1991;106: 85-9.
Soghikian K, Casper SM, Fireman BH, Hunkeler EM, Hurley LB, Tekawa IS, et al. Home blood pressure monitoring: effect on use of medical services and medical care costs. Med Care 1992;30: 855-65.
Muhlhauser I, Sawicki PT, Didjurgeit U, Jorgens V, Trampisch HJ, Berger M. Evaluation of a structured treatment and teaching programme on hypertension in general practice. Clin Exp Hypertens 1993;15: 125-42.
Friedman RH, Kazis LE, Jette A, Smith MB, Stollerman J, Torgerson J, et al. A telecommunications system for monitoring and counseling patients with hypertension: impact on medication adherence and blood pressure control. Am J Hypertens 1996;9: 285-92.
Zarnke KB, Feagan BG, Mahon JL, Feldman RD. A randomized study comparing a patient-directed hypertension management strategy with usual office-based care. Am J Hypertens 1997;10: 58-67.
Bailey B, Carney SL, Gillies AA, Smith AJ. Antihypertensive drug treatment: a comparison of usual care with self blood pressure measurement. J Hum Hypertens 1999;13: 147-50.
Mehos BM, Saseen JJ, MacLaughlin EJ. Effect of pharmacist intervention and initiation of home blood pressure monitoring in patients with uncontrolled hypertension. Pharmacotherapy 2000;20: 1384-9.
Vetter W, Hess L, Brignoli R. Influence of self-measurement of blood pressure on the responder rate in hypertensive patients treated with losartan: results of the SVATCH study. J Hum Hypertens 2000;14: 235-41.
Artinian NT, Washington OG, Templin TN. Effects of home telemonitoring and community-based monitoring on blood pressure control in urban African Americans: a pilot study. Heart Lung 2001;30: 191-9.
Broege PA, James GD, Pickering TG. Management of hypertension in the elderly using home blood pressures. Blood Press Monit 2001;6: 139-44.
Rogers MA, Small D, Buchan DA, Butch CA, Stewart CM, Krenzer BE, et al. Home monitoring service improves mean arterial pressure in patients with essential hypertension: a randomized, controlled trial. Ann Intern Med 2001;134: 1024-32.
Egger M, Davey SG, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997;315: 629-34.
Sutton AJ, Song F, Gilbody SM, Abrams KR. Modelling publication bias in meta-analysis: a review. Stat Methods Med Res 2000;9: 421-45.
Sutton AJ, Duval SJ, Tweedie RL, Abrams KR, Jones DR. Empirical assessment of effect of publication bias on meta-analyses. BMJ 2000;320: 1574-7.
Aylett M, Marples G, Jones K. Home blood pressure monitoring: its effect on the management of hypertension in general practice. Br J Gen Pract 1999;49: 725-8.
Brueren MM, Schouten HJA, de Leeuw PW, van Montfrans GA, van Ree JW. A series of self-measurements by the patient is a reliable alternative to ambulatory blood pressure measurement. Br J Gen Pract 1998;48: 1585-9.
Nordmann A, Frach B, Walker T, Martina B, Battegay E. Reliability of patients measuring blood pressure at home: prospective observational study. BMJ 1999;319: 1172.
Little P, Barnett J, Barnsley L, Marjoram J, Fitzgerald-Barron A, Mant D. Comparison of agreement between different measures of blood pressure in primary care and daytime ambulatory blood pressure. BMJ 2002;325: 254.
Little P, Barnett J, Barnsley L, Marjoram J, Fitzgerald-Barron A, Mant D. Comparison of acceptability of and preferences for different methods of measuring blood pressure in primary care. BMJ 2002;325: 258-9.
Staessen JA, Den Hond E, Celis H, Fagard R, Keary L, Vandenhoven G, et al. Antihypertensive treatment based on blood pressure measurement at home or in the physician's office. JAMA 2004;291: 955-64.
Williams B, Poulter NR, Brown MJ, Davis M, McInnes GT, Potter JF, et al. Guidelines for management of hypertension: report of the fourth working party of the British Hypertension Society, 2004—BHS IV. J Hum Hypertens 2004;18: 139-85.(Francesco P Cappuccio, pr)
Correspondence to: F P Cappuccio f.cappuccio@sghms.ac.uk
Abstract
High blood pressure is one of the most readily preventable causes of stroke and other cardiovascular complications.1-4 It can be easily detected, and most cases have no underlying detectable cause; the most effective way to reduce the associated risk is to reduce the blood pressure. Unlike many other common, chronic conditions, we have very effective ways of treating high blood pressure and we have clear evidence of the benefits of such interventions.1 However, despite a great deal of time and effort, hypertension is still underdiagnosed and undertreated.5 Furthermore, losses to follow up are high and are responsible for avoidable vascular deaths.6
Blood pressure is usually measured and monitored in the healthcare system by doctors or nurses in hospital outpatient departments and, increasingly, in primary care settings. New electronic devices have been introduced and validated in the clinical setting to replace the mercury sphygmomanometer and to overcome the large variations in measurement due to variability between observers. Ambulatory blood pressure monitoring is also being used more often to assess individuals' blood pressures outside the clinical setting.
Measuring blood pressure at home is becoming increasingly popular with both doctors and patients.7 8 Some national and international guidelines also recommend home monitoring in certain circumstances.9 A recent qualitative review of the role of home blood pressure measurement in managing hypertension concluded that no evidence exists as to whether home monitoring leads to better control of high blood pressure.10
We reviewed the literature on home blood pressure monitoring and did a meta-analysis of the effect of home monitoring on blood pressure levels and the control of hypertension in randomised trials that compared home or "self" blood pressure monitoring and usual blood pressure monitoring in the healthcare system.
Methods
We identified 18 randomised controlled trials that compared blood pressure control or the proportion of people with blood pressure above target. The table shows the characteristics of the analysed trials. Six were based in hospital outpatient clinics,14 19 21 22 25 31 eight in communities and general practices,16 18 23 24 26-29 and four in mixed settings.15 17 20 30 Treatment in the "control" group was mainly "usual" or "standard" care,15-19 21 22 24-29 31 but some trials had nurse clinics,14 30 educational interventions,20 or flagged medical records.23 Trials used different methods of home or self blood pressure monitoring. In total, 1359 people were randomised to home or self blood pressure monitoring and 1355 to a control group of blood pressure monitoring by health professionals in clinical settings. Two trials used a factorial design,16 18 four had more than two randomised groups,17 19 20 29 and one was randomised in clusters.23 Only in eight trials was outcome assessment stated to have been blind,14-16 24 25 29 31 and only in nine was randomisation concealed.15-18 20 21 24 29 31 The duration of the intervention varied between two months31 and 36 months.19
Characteristics of trials included in meta-analysis of home or self blood pressure monitoring
Systolic blood pressure
Thirteen studies reported systolic blood pressure at follow up and baseline or the change from baseline (see appendix D1 on bmj.com), but only five of these studies reported full data on means and the standard deviation of the difference. For the remaining seven studies we estimated standard deviations. The overall effect of intervention was 4.2 (95% confidence interval 1.5 to 6.9) mm Hg, with highly significant heterogeneity between studies (P < 0.001) (fig 2, top panel). The funnel plot showed some asymmetry, and Egger's test for publication bias was significant (P = 0.038) (fig 3, top panel). The trim and fill method estimated three missing studies and gave a revised estimate of 2.2 (-0.9 to 5.3) mm Hg.
Fig 2 Standardised mean differences (95% confidence interval) in systolic (top), diastolic (middle), and mean (bottom) blood pressures achieved in people monitoring blood pressure at home compared with people whose blood pressure was monitored by health professionals in clinical settings
Fig 3 Funnel plots for systolic and diastolic blood pressure
Diastolic blood pressure
Sixteen studies reported diastolic blood pressure at follow up and baseline or the change from baseline (see appendix D2 on bmj.com), but only eight of these studies reported full data on means and the standard deviation of the difference. For the remaining eight studies we estimated standard deviations. One study had multiple endpoints.19 We included results from the one year endpoint. Use of the two year endpoint did not make an important difference to the results (2.2 (1.0 to 3.3) mm Hg). The overall effect of intervention was 2.4 (1.2 to 3.5) mm Hg, with significant heterogeneity between studies (P = 0.014) (fig 2, middle panel). The funnel plot showed some asymmetry (fig 3, bottom panel) (Egger's test for publication bias, P = 0.095). The trim and fill method estimated two missing studies and gave a revised estimate of 1.9 (0.6 to 3.2) mm Hg.
Mean arterial pressure
Three studies reported mean arterial pressure, one of which did not report either systolic or diastolic blood pressure.25 All studies reported change from baseline (see appendix D3 on bmj.com) with standard deviation of the difference. The overall effect was 4.4 (2.0 to 6.8) mm Hg, with no significant heterogeneity (P = 0.319) (fig 2, bottom panel).
Blood pressure above target
Six studies reported the number of patients whose blood pressure was controlled at follow up. Different definitions of blood pressure control were used (see appendix C on bmj.com). Two studies reported the outcome at more than one time point. The analysis reported here is for the one year outcome in both studies. The overall relative risk was 0.90 (0.80 to 1.00), with no significant heterogeneity between studies (P = 0.34) (fig 4). Inclusion of the two year outcomes for Earp17 and Stahl19 slightly reduced the effect—relative risk 0.92 (0.83 to 1.04).
Fig 4 Standardised relative risk of blood pressure above target in people monitoring blood pressure at home compared with people whose blood pressure was monitored by health professionals in clinical settings
Discussion
Collins R, Peto R, MacMahon S, Hebert P, Fiebach NH, Eberlein KA, et al. Blood pressure, stroke and coronary heart disease. II. Short term reductions in blood pressure: overview of randomised drug trials in their epidemiological context. Lancet 1990;335: 827-38.
MacMahon S, Peto R, Cutler J, Collins R, Sorlie P, Neaton J, et al. Blood pressure, stroke and coronary heart disease. I. Effect of prolonged differences in blood pressure: evidence from nine prospective observational studies corrected for the regression dilution bias. Lancet 1990;335: 765-74.
Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002;360: 1903-13.
Prospective Studies Collaboration. Cholesterol, diastolic blood pressure, and stroke: 13,000 strokes in 450,000 people in 45 prospective cohorts. Lancet 1995;346: 1647-53.
Primatesta P, Brookes M, Poulter NR. Improved hypertension management and control: results from the health survey for England 1998. Hypertension 2001;38: 827-32.
Du X, Cruickshank K, McNamee R, Saraee M, Sourbutts J, Summers A, et al. Case-control study of stroke and the quality of hypertension control in north west England. BMJ 1997;314: 272-6.
Yarows SA, Staessen JA. How to use home blood pressure monitors in clinical practice. Am J Hypertens 2002;15: 93-6.
Yarows SA, Julius S, Pickering TG. Home blood pressure monitoring. Arch Intern Med 2000;160: 1251-7.
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA 2003;289: 2560-71.
Rickerby J. The role of home blood pressure measurement in managing hypertension: an evidence-based review. J Hum Hypertens 2002;16: 469-72.
Cartwright W, Dalton KJ, Swindells H, Rushant S, Mooney P. Objective measurement of anxiety in hypertensive pregnant women managed in hospital and in the community. Br J Obstet Gynaecol 1992;99: 182-5.
Glanz K, Kirscht JP, Rosenstock IM. Linking research and practice in patient education for hypertension: patient responses to four educational interventions. Med Care 1981;19: 141-52.
Ross-McGill H, Hewison J, Hirst J, Dowswell T, Holt A, Brunskill P, et al. Antenatal home blood pressure monitoring: a pilot randomised controlled trial. Br J Obstet Gynaecol 2000;107: 217-21.
Carnahan.JE, Nugent CA. The effects of self monitoring by patients on the control of hypertension. Am J Med Sci 1975;269: 69-73.
Haynes RB, Sackett DL, Gibson ES, Taylor DW, Hackett BC, Roberts RS, et al. Improvement of medication compliance in uncontrolled hypertension. Lancet 1976;i: 1265-8.
Johnson AL, Taylor DW, Sackett DL, Dunnett CW, Shimizu AG. Self-recording of blood pressure in the management of hypertension. CMAJ 1978;119: 1034-9.
Earp JA, Ory MG, Strogatz DS. The effects of family involvement and practitioner home visits on the control of hypertension. Am J Public Health 1982;72: 1146-54.
Pierce JP, Watson DS, Knights S, Gliddon T, Williams S, Watson R. A controlled trial of health education in the physician's office. Prev Med 1984;13: 185-94.
Stahl SM, Kelley CR, Neill PJ, Grim CE, Mamlin J. Effects of home blood pressure measurement on long-term BP control. Am J Public Health 1984;74: 704-9.
Binstock ML, Franklin KL. A comparison of compliance techniques on the control of high blood pressure. Am J Hypertens 1988;1: 192-4S.
Midanik LT, Resnick B, Hurley LB, Smith EJ, McCarthy M. Home blood pressure monitoring for mild hypertensives. Public Health Rep 1991;106: 85-9.
Soghikian K, Casper SM, Fireman BH, Hunkeler EM, Hurley LB, Tekawa IS, et al. Home blood pressure monitoring: effect on use of medical services and medical care costs. Med Care 1992;30: 855-65.
Muhlhauser I, Sawicki PT, Didjurgeit U, Jorgens V, Trampisch HJ, Berger M. Evaluation of a structured treatment and teaching programme on hypertension in general practice. Clin Exp Hypertens 1993;15: 125-42.
Friedman RH, Kazis LE, Jette A, Smith MB, Stollerman J, Torgerson J, et al. A telecommunications system for monitoring and counseling patients with hypertension: impact on medication adherence and blood pressure control. Am J Hypertens 1996;9: 285-92.
Zarnke KB, Feagan BG, Mahon JL, Feldman RD. A randomized study comparing a patient-directed hypertension management strategy with usual office-based care. Am J Hypertens 1997;10: 58-67.
Bailey B, Carney SL, Gillies AA, Smith AJ. Antihypertensive drug treatment: a comparison of usual care with self blood pressure measurement. J Hum Hypertens 1999;13: 147-50.
Mehos BM, Saseen JJ, MacLaughlin EJ. Effect of pharmacist intervention and initiation of home blood pressure monitoring in patients with uncontrolled hypertension. Pharmacotherapy 2000;20: 1384-9.
Vetter W, Hess L, Brignoli R. Influence of self-measurement of blood pressure on the responder rate in hypertensive patients treated with losartan: results of the SVATCH study. J Hum Hypertens 2000;14: 235-41.
Artinian NT, Washington OG, Templin TN. Effects of home telemonitoring and community-based monitoring on blood pressure control in urban African Americans: a pilot study. Heart Lung 2001;30: 191-9.
Broege PA, James GD, Pickering TG. Management of hypertension in the elderly using home blood pressures. Blood Press Monit 2001;6: 139-44.
Rogers MA, Small D, Buchan DA, Butch CA, Stewart CM, Krenzer BE, et al. Home monitoring service improves mean arterial pressure in patients with essential hypertension: a randomized, controlled trial. Ann Intern Med 2001;134: 1024-32.
Egger M, Davey SG, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997;315: 629-34.
Sutton AJ, Song F, Gilbody SM, Abrams KR. Modelling publication bias in meta-analysis: a review. Stat Methods Med Res 2000;9: 421-45.
Sutton AJ, Duval SJ, Tweedie RL, Abrams KR, Jones DR. Empirical assessment of effect of publication bias on meta-analyses. BMJ 2000;320: 1574-7.
Aylett M, Marples G, Jones K. Home blood pressure monitoring: its effect on the management of hypertension in general practice. Br J Gen Pract 1999;49: 725-8.
Brueren MM, Schouten HJA, de Leeuw PW, van Montfrans GA, van Ree JW. A series of self-measurements by the patient is a reliable alternative to ambulatory blood pressure measurement. Br J Gen Pract 1998;48: 1585-9.
Nordmann A, Frach B, Walker T, Martina B, Battegay E. Reliability of patients measuring blood pressure at home: prospective observational study. BMJ 1999;319: 1172.
Little P, Barnett J, Barnsley L, Marjoram J, Fitzgerald-Barron A, Mant D. Comparison of agreement between different measures of blood pressure in primary care and daytime ambulatory blood pressure. BMJ 2002;325: 254.
Little P, Barnett J, Barnsley L, Marjoram J, Fitzgerald-Barron A, Mant D. Comparison of acceptability of and preferences for different methods of measuring blood pressure in primary care. BMJ 2002;325: 258-9.
Staessen JA, Den Hond E, Celis H, Fagard R, Keary L, Vandenhoven G, et al. Antihypertensive treatment based on blood pressure measurement at home or in the physician's office. JAMA 2004;291: 955-64.
Williams B, Poulter NR, Brown MJ, Davis M, McInnes GT, Potter JF, et al. Guidelines for management of hypertension: report of the fourth working party of the British Hypertension Society, 2004—BHS IV. J Hum Hypertens 2004;18: 139-85.(Francesco P Cappuccio, pr)