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Objective: To explore in a primary care setting the associations between patients' daily self-measured blood pressure (BP) during eight weeks and concurrent self-reported values of wellbeing, lifestyle, symptoms, and medication intake. We also explore these associations for men and women separately. Design and setting: The study is a secondary post-hoc analysis of the randomised controlled trial PERson-centeredness in Hypertension management using Information Technology (PERHIT). The trial was conducted in primary health care in four regions in Southern Sweden. Patients: Participants (n = 454) in the intervention group in the PERHIT-trial used an interactive web-based system for self-management of hypertension for eight consecutive weeks. Each evening, participants reported in the system their wellbeing, lifestyle, symptoms, and medication adherence as well as their self-measured BP and heart rate. Main outcome measures: Association between self-reported BP and 10 self-report lifestyle-related variables. Results: Self-reported less stress and higher wellbeing were similarly associated with BP, with 1.0 mmHg lower systolic BP and 0.6/0.4 mmHg lower diastolic BP (p < 0.001). Adherence to medication had the greatest impact on BP levels (5.2/2.6 mmHg, p < 0.001). Restlessness and headache were also significantly associated with BP, but to a lesser extent. Physical activity was only significantly associated with BP levels for men, but not for women. Conclusion: In hypertension management, it may be important to identify patients with high-stress levels and low wellbeing. The association between medication intake and BP was obvious, thus stressing the importance of medication adherence for patients with hypertension. KEY POINTS: Associations between daily home blood pressure (BP) and self-reports of lifestyle and symptoms have not been previously well explored. Self-reported higher wellbeing, lower restlessness, less stress, and higher medication adherence were significantly associated with lower same-day BP levels. Physical activity was significantly associated with same-day BP for men, but not for women. Using a hypertension management system may be a valuable tool for communication between the patient and physician. [ABSTRACT FROM AUTHOR]

Background: Although intensive blood pressure (BP) control has not been shown to slow the progression of chronic kidney disease (CKD), intensive BP control has been shown to reduce the risk for adverse cardiovascular outcomes in the CKD population. The aim of this post-hoc study was to study the interplay between a self-monitoring BP system and glomerular function., Methods: In all, 949 participants with hypertension underwent visits at baseline, after eight weeks and 12 months. Half of the participants received a BP monitor and installed a program on their mobile phone. During eight weeks, they measured daily and reported their BP values., Results: Within the intervention group, BP and systolic BP (SBP) decreased from baseline to eight weeks and 12 months ( p  < .001). Pulse pressure (PP) and mean arterial blood pressure (MAP) decreased from baseline to eight weeks ( p  = .021 and p  = .004) vs 12 months ( p  = .035 and p  = .008). Within the control group, a decrease was observed from baseline to 12 months for SBP, diastolic BP (DBP) and PP ( p  = .025, p  = .023 and p  = .036). In the intervention group, we observed an association between a decrease in SBP, DBP, PP and MAP and a decrease in eGFR (estimated glomerular filtration rate), ( p  < .001, p  < .001, p  = .013 and p  < .001). In the control group, similar results were observed for PP only ( p  = .027). Within the intervention group, eGFR decreased ( p  < .001) but within the control group, the decrease was non-significant ( p  = .051)., Conclusion: We observed an association between a decrease in all BP components and eGFR decline within the normal range in the intervention group but not in the controls., Trial Registration: The study was registered with ClinicalTrials.gov [NCT03554382].