Home blood pressure monitoring in slovakia in 2022. who manages the patients with arterial hypertension the best?

Objective: Home blood pressure monitoring (HBPM) is a reliable, convenient method for the diagnosis and management of arterial hypertension (AH). Moreover, HBPM can help improve the control of blood pressure in patients (pts). Design and method: To evaluate HBPM and office blood pressure (BP) measurements. To compare the efficacy of the AH treatment according to doctors‘ and patients‘ age and gender. Results: 4375 pts with AH were enrolled (2089 women, 51,8%), mean age 61,1 ± 19,1 years. The mean office BP was higher in male pts 136,7 ± 10,9/ 81,9 ± 7,2 mmHg, vs in female pts 135±7,2/ 80,2 ± 6,2 mmHg. Mean HBPM was also higher in male pts 134,1± 7,2/ 81,1± 6,3 mmHg. In our program participated 129 female doctors (72%), mean age of 49,6 ± 10,1 years, and the mean age of male doctors was 44,9 ± 7,2 years. The reduction in BP for 7 days of HBPM was documented. A greater reduction of HBPM was achieved when the female doctor treated female patients 132,01/78 mmHg p = 0,0081, contrary to a smaller reduction of BP when the female doctor treated male pts 134,18/81,32 mmHg p = 0,026. The highest office BP was measured in male pts treated by male doctors 136,59/81,59 mmHg, beyond the lowest office BP was measured when the female doctor treated female pts 132,01/78,74 mmHg p = 0,0081. Male doctors treated more frequently with a higher number of AH drugs. The proportion of use of fixed-dose AH drugs combination was highest when the male doctor treated male pts (70,7%), and the lowest use of fixed-dose combination was when the female doctor treated female patients 52,1%. Conclusions: In our project with HBPM and office BP measurement in 2022 in Slovakia we found that the most precise BP control both in the office and in HBPM was reached when female patients were treated by female doctors. On the other hand, male doctors have preferred to use fixed-dose AH combinations. These data show that better involvement and engagement of doctors, and patients could lead to better implementation of guidelines and better BP control.