Because there has been some disagreement regarding the effectiveness of home monitoring, Dr. Ilkka Kantola, from Turku University Hospital in Finland, and colleagues conducted a study involving 55 primary health care centers. A group of 113 patients measured blood pressure at home using an automated device twice daily for 7 days and then again at 2, 4, and 6 months, and the results were returned to the patients' physicians. A comparison group of 119 patients had blood pressure measured in their primary care providers' offices at the same time periods. The doctors in both groups were instructed to intensify treatment if the target blood pressure was not met. At the end of the study, both groups experienced significant drops in blood pressure, but the effects were generally more pronounced in the home-monitoring group. Kantola's group also observed that significantly more patients in the home-monitoring group achieved their target blood pressure. This may be at least partially related to more changes in blood pressure medications during the study -- 85 changes in the home-monitoring group versus 73 in the comparison group. However, there remains room for improvement since many of the patients failed to meet their target blood pressure, the investigators add. Although the study suffers from various design limitations, its findings "highlight the potential role that self-monitoring of blood pressure can play in helping improve the management of high blood pressure in the community," Dr. Francesco P. Cappuccio, from Warwick Medical School in Coventry, UK, comments in an accompanying editorial. SOURCE: American Journal of Hypertension, November 2005.