Factors Associated With Home Blood Pressure Monitoring Among US Adults: National Health and Nutrition Examination Survey, 2011–2014

Abstract

Home blood pressure monitoring (HBPM) has a substantial role in hypertension management and control. Cross-sectional data for noninstitutionalized US adults 18 years and older (10,958) from the National Health and Nutrition Examination Survey (NHANES), years 2011–2014, were used to examine factors related to HBPM. In 2011–2014, estimated 9.5% of US adults engaged in weekly HBPM, 7.2% engaged in monthly HBPM, 8.0% engaged in HBPM less than once a month, and 75.3% didn’t engage any HBPM. The frequency of HBPM increased with age, body mass index, and the number of health care visits (all, P < 0.05). Also, race/ethnicity (Non-Hispanic Blacks and non-Hispanic Asians), health insurance, diagnosed with diabetes, told by a health care provider to engage in HBPM, and diagnosed as hypertensive, were all associated with more frequent HBPM (P < 0.05). Adjusting for covariates, hypertensives who were aware of, treated for, and controlled engaged in more frequent HBPM compared to their respective references: unaware (odds ratio [OR] = 2.00, 95% confidence interval [CI] = 1.53–2.63), untreated (OR = 1.99, 95% CI = 1.52–2.60), and uncontrolled (OR = 1.42, 95% CI = 1.13–1.82). Hypertensive adults (aware/unaware, treated/untreated, or controlled/uncontrolled), who received providers’ recommendations to perform HBPM, were more likely to do so compared to those who did not receive recommendations (OR = 8.04, 95% CI = 6.56–9.86; OR = 7.98, 95% CI = 6.54–9.72; OR = 8.75, 95% CI = 7.18–10.67, respectively). Seventeen percent of US adults engaged in monthly or more frequent HBPM and health care providers’ recommendations to engage in HBPM have a significant impact on the frequency of HBPM.