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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003ESelf-management of hypertension with self-monitoring of blood pressure levels and self-titration of antihypertensive medications results in significantly lower systolic blood pressure compared with usual care, according to findings from the Telemonitoring And Self-Management In The Control Of Hypertension [TASMINH2] trial.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EHypertensive Disease Clinical Trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003ESelf-management of hypertension with self-monitoring of blood pressure (BP) levels and self-titration of antihypertensive medications results in significantly lower systolic blood pressure (SBP) compared with usual care, according to findings from the Telemonitoring And Self-Management In The Control Of Hypertension (TASMINH2) trial.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003ERecent improvements in automated BP meters have lead to the widespread use of self-monitoring by patients with hypertension. However, the effectiveness of a self-management intervention that combines self-monitoring with self-titration of antihypertensive medication in the primary care setting is unknown. Richard J. McManus, University of Birmingham, Birmingham, UK, reported findings from the TASMINH2 trial (\u003Ca href=\u0022\/external-ref?link_type=ISRCTN\u0026amp;access_num=ISRCTN17585681\u0022 class=\u0022external-ref external-ref-type-isrctn\u0022\u003EISRCTN17585681\u003C\/a\u003E), which was designed to evaluate the role of dual-intervention self-management in reducing BP levels in patients with poorly controlled hypertension.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EThe TASMINH2 trial included 480 patients with elevated BP levels (\u0026gt;140\/90 mm Hg) who had previously been treated with up to 2 antihypertensive medications. Patients were randomly assigned to self-management (n=246) or usual care (n=234). Patients in the self-management group agreed to perform monthly self-monitoring of BP levels. Based on BP findings, patients in the self-management group also followed medication titration schedules that were individually tailored to each patient\u0027s guideline-recommended BP goals. The primary endpoint was SBP at 6 and 12 months.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003ESelf-management was associated with greater reductions in mean SBP compared with usual care at 6 months (\u221212.9 mm Hg vs \u22129.2 mm Hg; p=0.013) and at 12 months (\u221217.6 mm Hg vs \u221212.2 mm Hg; p=0.0004). At 6 months, patients in the self-management and usual-care groups showed similar decreases in diastolic BP (DBP; \u22125.4 mm Hg vs \u22124.2 mm Hg; p=0.108). However, by 12 months, self-management showed a significant advantage in DBP reduction compared with usual care (\u22127.6 mm Hg vs \u22125.0 mm Hg; p=0.001).\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EGreater BP control within the self-management group may be due to increased use of antihypertensive medication. Overall, 212 patients (80%) in the self-management group adhered to the self-monitoring and self-management regimen for the full 12 months of the study. Of these, 148 patients (70%) made at least one change to their antihypertensive treatment regimen during the course of the study. Indeed patients in the self-management group were significantly more likely than those in the usual care group to change medications during the study, with a mean of 0.46 more changes by month 12 (p=0.001). The most common agents added to the antihypertension treatment regimens were thiazide diuretics and calcium channel blockers.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003ESelf-management was well tolerated. Patients had similar rates of side effects in both treatment arms with the exception of leg swelling, which occurred more frequently in the self-management group than in the usual care group (32% vs 22%; p=0.022).\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EFindings from TASMINH2 demonstrate the effectiveness of the self-monitoring of BP levels and the self-titration of BP medication in patients with uncontrolled hypertension. Self-management represents an important new intervention in the management of hypertension in primary care, Prof. McManus concluded.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2010 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/10\/5\/10.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzmqwd\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}