Color-Coded Blood Pressure Control

Arterial hypertension (AH) is the most common chronic disease among Swiss adults apart from dyslipidemia and diabetes mellitus.1 Worldwide, the prevalence of AH among adults is estimated to be 26%, representing a major risk factor for cardiovascular morbidity and mortality.2,3 Even though effective medication and guidelines for the treatment and management of AH exist,4 the control of high blood pressure (BP) in the community is far from optimum.5 In order to reach treatment goals in a chronic condition, adherence with treatment and patient collaboration are essential. To successfully cope with and manage a chronic disease in the long term it is necessary to acquire skills and to change behavior. Home BP measurement (HBPM) is an important skill for patients to monitor their disease and has been consistently recommended in hypertension guidelines.6,7 Yet low adherence with self-monitoring and treatment recommendations remains problematic in daily practice.8 While a vast amount of data exist regarding AH and adherence with treatment,9–11 relatively few studies and reviews have explored how adherence and patient self-monitoring ability can be supported and improved, and the conclusions of these studies are not consistent.12–17 Recommendations for research on interventions to improve adherence encourage development of interventions that are simple and easily applicable to the clinical setting.18 The aim of the Color-coded blood pressure Control (CoCo) trial was therefore to analyze the effect of a simple, practical tool, ie, a color-coded BP booklet with a traffic light scheme for self-monitoring, on BP control and adherence with self-measurements.