Achieving blood pressure control with monotherapy: real-world evidence from office and home blood pressure measurements

Abstract

Despite guidelines discouragement, antihypertensive monotherapy (AH-mono) remains widely used. This study assessed AH-mono prevalence and blood pressure control rates based on office and home measurements (OBP/ HBPM) using contemporary targets (<130/80mmHg). Three distinct cohorts undergoing OBP/HBPM assessments between July 2018 and July 2024 were analyzed: cohort 1 (n=63164) included treated patients with a single OBP/ HBPM measurement; cohort 2 (n=5676) comprised treated patients with two OBP/HBPM assessments at different time points; and cohort 3 (n=974) involved individuals with OBP/HBPM measurements before and after initiating antihypertensive therapy. The prevalence of AHmono was 42.7% in cohort 1, 36.6 and 32.4% in cohort 2, and 50.7% in cohort 3. Among those receiving AHmono, OBP/HBPM control rates were 8.5% in cohort 1, 6.7 and 7.3% in Cohort 2, and 7.7% in cohort 3. These real-world findings highlight the persistent high prevalence of AH-mono despite its limited efficacy, with less than 10% of patients achieving blood pressure control. Graphical abstract: http://links.lww.com/HJH/C820