Around 40% of adults in the UK are pre-hypertensive (PHT). PHT is not an illness but is an indicator that the person has raised blood pressure above the normal level. It is a warning that their blood pressure may increase to the level of hypertension, requiring medications and other interventions. People with pre- hypertension have a high risk of developing hypertension and cardiovascular (stroke, heart disease) conditions.
We already know that self-monitoring of blood pressure for people with hypertension is effective in helping people manage this and to reduce risk of health problems. Self-monitoring of blood pressure may increase people’s awareness of blood pressure levels and prompt people with raised blood pressure (pre-hypertension) to modify their lifestyle (e.g. changing their diet, stopping smoking, and increasing physical activity). However, this approach hasn’t been tested for pre-hypertension before.
High blood pressure increases the risk of cardiovascular disease. Raised blood pressure occurs before someone crosses the threshold of high blood pressure. People are not usually made aware of raised blood pressure, even though it is known to increase the risk of heart attack, stroke and cardiovascular disease. By identifying and alerting people to raised blood pressure, an intervention might prevent cardiovascular disease. This may protect health and quality of life. It may also help health professionals to reduce the cost and workload caused by preventable cardiovascular diseases.
Determine the willingness of people in pre-hypertension range, and health service providers, to take part in a self-monitoring intervention.
Assess and evaluate the acceptability of the intervention and study processes.
Gather information to decide whether a further study is needed and to help design that study.
Design and Methods
We are recruiting around 100 people from pharmacies, GPs and work-place providers in Lancashire offering the NHS Health Check. People aged 18+, with raised blood pressure who are not taking medication for hypertenstion, will be invited to take part. Participants must not have had a diagnosis of high blood pressure. We will provide equipment for participants to self-monitor their blood pressure at home. They will record two blood pressure readings on three days every month, for six months. To find out if self-monitoring is acceptable to participants and the health professionals, we will interview them. We will ask about their experiences with self-monitoring, its benefits, any problems they have experienced, and how it might be improved. To find out if self-monitoring is feasible for members of the public we will assess the time taken to recruit the target number of eligible people, the number of people who are recruited but who do not complete the study, and whether people actually check their blood pressure on schedule. This will help decide whether a future larger study is needed, looking at the impact self-monitoring has on people's health, longer-term.
