Follow-up in patients on long-term antihypertensive treatment

Many patients (particularly middle-aged and still working) on long-term antihypertensive treatment consider follow-up visits unnecessary as long as their home blood pressure (BP) measurements are normal and drugs can be ordered by phone. Are follow-up visits (eg, every 3 months) really needed?

Ally Prebtani, MD: That is a good question. It depends on how long they have had good control for. If someone is really well controlled, they are doing home BP monitoring periodically, and they do not have other ongoing medical issues or end-organ effects from their hypertension, then probably a visit once a year is good enough.

But if someone is having a lot of difficulties with side effects, with titrating their medications, or they are not reaching their BP targets, especially at home, then they probably need more frequent BP monitoring. That can be via frequent visits by their doctor or even phone call visits. There are some studies to show that even having telecommunication and titrating patients’ medication up or down may improve BP control and outcomes.