Plain language summary

High blood pressure, also known as hypertension, is when the pressure in the arteries that carry blood around the body is too high over a period of time. People with high blood pressure may not have any symptoms. People who think they have may have high blood pressure, or people taking medication for it should have their blood pressure checked regularly.

Blood pressure can be measured at home, away from a clinical setting using a blood pressure machine. The most accurate machines use a cuff that goes around the upper arm. People record their blood pressure at home, report their results to their clinician and then receive feedback on what should happen next.

High blood pressure can cause problems such as stroke, heart disease and heart attacks. Many people in Scotland go to the doctor because of high blood pressure. To help people stay healthy we need ways to prevent, treat and manage high blood pressure. This will also help us to make better use of NHS resources.

We looked at the evidence on using home blood pressure monitoring in people who have suspected or diagnosed high blood pressure and compared this with evidence on other methods of blood pressure measurement. We looked at whether home blood pressure monitoring was effective, safe and good value for money. We also looked at patient experiences of using home blood pressure monitoring.

We found that checking blood pressure at home, with extra help, can lower blood pressure in people with high blood pressure. We did not find clear evidence that it changed or predicted the risk of heart disease or death, or that it helped people to take their medicine regularly.

The studies we looked at found no problems with the safety of home blood pressure monitoring compared with attending a clinical appointment.

Research shows that checking blood pressure at home with help from professionals remotely is helpful. It can make people healthier and give them more control. It can save money for the NHS compared with attending routine appointments at the doctors. Our economic model showed that home blood pressure monitoring in Scotland (through the Connect Me service) costs less and has provides better health outcomes for people with high blood pressure compared with routine care.

People who checked their blood pressure at home thought it was easy, convenient, and helped them work better with their doctor overall. They wanted help with measuring their blood pressure, learning about it and feedback on their results. There were also people who found that measuring their blood pressure increased their anxiety levels and they did not want to measure it as often.

Monitoring blood pressure is reported to be effective, safe and acceptable to people with who have suspected or diagnosed high blood pressure. We do not know how monitoring blood pressure at home influences the number of people dying from conditions related to high blood pressure, or whether it helps people take their medications. It is hard to reach clear conclusions because the studies we found included different patient groups and varied in the way that they collected and reported high blood pressure readings.

NHSScotland will use our advice to decide if more people with high blood pressure should be supported to check their blood pressure at home.