In individuals with hypertension, lowering blood pressure after stroke can lower the risk of stroke recurrence, but many patients do not reach goal.  Home blood pressure monitoring (HBPM) can help patients achieve their goal. However, rates of use and quality of technique have not been evaluated, which we aim to evaluate in this cross-sectional study.

Hypertension (HTN) affects approximately 70% of patients with a recent stroke and treatment is highly effective in reducing risk for recurrence. In multiple studies the reduction of blood pressure, by life style changes or pharmacotherapy have significantly reduced the risk for fatal or non-fatal stroke. Therefore, blood pressure lowering is effective for secondary stroke prevention.

We conducted a cross-sectional study of patients with stroke.  Patients were eligible if they had a stroke within two years, had hypertension, and lived at home.  We classified patients as correctly performing HBPM if they used an arm cuff, sat >1 min before measurement, took >2 measurements, and use within 6 months.  The primary outcome was determine HBPM was used correctly. Which we calculated according to race and ethnicity.  We ask for additional steps if BP out of range.

Among 150 participants, 120 (81%) possessed a HBPM and 29 (21%) used it correctly.  We observed no significant disparity in rates of possession or correct use between non-Hispanic White participants and participants from underrepresented groups.  Seventy percent of non-Hispanic White patients said they would contact their provider if their BP was above goal vs. 52% of underrepresented patients (p=0.21). 

Most patients after stroke have a HBPM, but only about 1 in 5 use it correctly.  Approximately half of patients from underrepresented racial or ethnic groups do not have a plan for responding to values above goal.  Our results indicate opportunities to improve the dissemination and correct use of HBPM.