Factors influencing the continuation of home blood pressure measurement in community-dwelling older adults: the NOSE study

Abstract

Objective: This study aimed to identify the factors influencing home blood pressure measurement (HBPM) continuation in community-dwelling older adults. Methods: A longitudinal analysis used the NOSE study intervention group datasets. The participants were encouraged HBPM with self-monitoring devices provided to them twice in the morning and twice in the evening. Every 7-day interval from the HBPM start date was defined as 1 week, and the number of HBPMs per week was counted. The first week in which the number of HBPMs was zero was defined as the week in which HBPM was discontinued. Participants who did not experienced discontinuation until the end of the observation period were considered complete survivors in the survival time analysis. Results: Data from 437 participants were included in the analysis. Of these, 120 (27.5%) discontinued HBPM. In univariate analysis, factors significantly associated with HBPM discontinuation included exercise habits [hazard ratio per one unit 0.47; 95% confidence interval (CI) 0.31-0.69], social participation (hazard ratio 0.65; 95% CI 0.42–0.99), MoCA-J score (hazard ratio 0.94; 95% CI 0.90–0.98), and frailty (hazard ratio 5.20; 95% CI 2.87–9.43). In multivariate analysis, factors significantly associated with HBPM discontinuation included sex (hazard ratio 0.55; 95% CI 0.32–0.95; ref. = female individuals), smoking history (hazard ratio 1.69; 95% CI 1.02–2.80), exercise habits (hazard ratio 0.51; 95% CI 0.30–0.85), MoCA-J score (hazard ratio 0.93; 95% CI 0.88–0.98), and frailty (hazard ratio 3.31; 95% CI 1.50–7.29). Conclusion: Among community-dwelling older adults, female sex, smoking history, lack of exercise, cognitive decline, and frailty were identified as factors influencing HBPM discontinuation.