{
  "release_id": "2b2017b84496b985",
  "id": "core:home-bp-monitoring",
  "owner": "core",
  "kind": "intervention",
  "slug": "home-bp-monitoring",
  "name": "Home blood pressure monitoring",
  "aliases": [
    "Self-measured blood pressure monitoring",
    "SMBP",
    "HBPM"
  ],
  "atlases": [
    "cardio",
    "maternal"
  ],
  "summary_plain": "Measuring your own blood pressure with a device, at home or somewhere else outside the clinic.",
  "summary_technical": "Also called self-measured blood pressure (SMBP) monitoring. The CDC describes the patient measuring blood pressure regularly outside the clinic, at home or elsewhere, with a home device and at different times. The JACC panel says self-monitored blood pressure is frequently measured in the home and also in public places, so the home is one setting of it. MeSH has a concept named Blood Pressure Monitoring, Home (M0456886), filed under the descriptor Blood Pressure Monitoring, Ambulatory (D018660). That concept's label and scope note name only the home, so it is not an exact match and no MeSH id is recorded. Recommendations, accuracy and effects belong in cited claims.",
  "editorial_state": "draft",
  "last_substantive_edit": "2026-10-11",
  "last_evidence_check": "2026-10-11",
  "next_review_due": null,
  "external_ids": [],
  "navigation": {
    "cardio": {
      "system": [
        "blood-vessels"
      ],
      "condition-area": [
        "hypertension"
      ]
    }
  },
  "payload": {
    "subtype": "test",
    "mechanism": "The person measures their own blood pressure with a home blood pressure device, at different points in time, outside the clinic.",
    "taxonomy_codes": []
  },
  "content_digest": "6ef310cdbe55ebb6b2354fbfcc31c62445aca7e70e7517837d45d84f86b1c0ae",
  "review": {
    "content_digest": "6ef310cdbe55ebb6b2354fbfcc31c62445aca7e70e7517837d45d84f86b1c0ae",
    "current": [],
    "conflicting": [],
    "stale": [],
    "inactive": []
  },
  "claims": [
    {
      "release_id": "2b2017b84496b985",
      "id": "cardio:claim-nice-ng136-1-2-4",
      "owner": "cardio",
      "subject_entity_id": "core:home-bp-monitoring",
      "category": "recommendation",
      "statement": "NICE guideline NG136 recommends offering home blood pressure monitoring (HBPM) to confirm a diagnosis of hypertension in adults when ABPM is not suitable or not tolerated.",
      "context": {
        "id": "cardio:ctx-nice-adults-suspected-hypertension",
        "label": "Adults with suspected hypertension, clinic blood pressure 140/90 to 180/120 mmHg (NICE NG136 1.2)",
        "recipient": "adult",
        "population": "Adults aged 18 and over who are assessed for hypertension, with or without type 2 diabetes. Recommendations 1.2.3 and 1.2.4 concern a clinic blood pressure between 140/90 mmHg and 180/120 mmHg. Recommendation 1.2.8 concerns a clinic reading of 140/90 mmHg or higher followed by ambulatory or home monitoring.",
        "care_setting": "Clinic measurement first, then ambulatory or home blood pressure monitoring (NICE recommendations 1.2.3, 1.2.4 and 1.2.8)",
        "geography": "England, from clause 6 of the NICE terms and conditions, which presents the information as support for people in England who make decisions about funding care. Clause 8 adds that NICE does not write its content as a basis for decisions outside the United Kingdom. The NG136 page itself states no jurisdiction.",
        "life_stage": "Adult (aged 18 and over)",
        "gestational_age_min_days": null,
        "gestational_age_max_days": null,
        "postnatal_age_min_days": null,
        "postnatal_age_max_days": null,
        "gestational_age_status": null,
        "postnatal_age_status": null,
        "followup_description": "Not applicable (recommendation context)",
        "eligibility": {
          "inclusion": [
            "Adult aged 18 and over (NICE NG136 Overview chapter)",
            "Clinic blood pressure between 140/90 mmHg and 180/120 mmHg (recommendations 1.2.3 and 1.2.4)",
            "With or without type 2 diabetes (introductory text to the NG136 recommendations)"
          ],
          "exclusion": [
            "Pregnancy is outside this atlas context. NICE has a separate guideline on hypertension in pregnancy, and the fetched diagnosis recommendations state no separate pregnancy exclusion.",
            "A clinic blood pressure of 180/120 mmHg or higher is handled in the NG136 referral section, which this context does not cover."
          ]
        }
      },
      "evidence_stage": "guidance",
      "certainty": "not_assessed",
      "certainty_method": null,
      "limitations": "NICE gives no strength label for this recommendation. Its verb is offer. NICE says it uses that verb where the evidence of benefit is strong and leaves little doubt. How NICE applied that convention here was not verified. The NG136 page states no jurisdiction. NICE's terms present the information as support for people in England who make decisions about funding care, and say the content is not written as a basis for decisions outside the United Kingdom. The recommendation carries the year tag 2019, the year of NICE's evidence review. No NICE evidence review was read. NICE places this recommendation second, after ABPM. This claim records what NICE recommends. It does not say how well home monitoring performs, and it covers no pregnancy use.",
      "editorial_state": "draft",
      "checked_at": "2026-10-11",
      "next_review_due": null,
      "valid_from": null,
      "valid_to": null,
      "citations": [
        {
          "evidence_role": "supports",
          "locator": "Recommendation 1.2.4",
          "applicability_note": "NICE NG136 as shown on 2026-10-11, last updated 2026-02-26. Offer HBPM when ABPM is unsuitable or not tolerated.",
          "snapshot": {
            "id": "cardio:nice-ng136-recs-2026-10-09",
            "retrieved_at": "2026-10-09T15:59:21Z",
            "content_hash": "68ce72f3487ffa4715f92ddfa8aaf6e093f5aecd3598cd59a0ab58f74ce86f28",
            "source_effective_date": "2026-02-26",
            "public_archive_url": null,
            "source_state": "current"
          },
          "source": {
            "id": "cardio:nice-ng136",
            "source_type": "guideline",
            "title": "Hypertension in adults: diagnosis and management (NICE guideline NG136), Recommendations chapter",
            "canonical_url": "https://www.nice.org.uk/guidance/ng136/chapter/Recommendations",
            "identifier_namespace": "nice",
            "identifier_value": "NG136",
            "publication_date": "2019-08-28",
            "publisher": "National Institute for Health and Care Excellence (NICE)",
            "edition": "The Recommendations chapter as shown on 2026-10-09 and fetched again on 2026-10-11 with identical bytes. The page header gives 26 February 2026 as the last update. This atlas cites six recommendations from it, each with the version tag the page shows: 1.1.3 is tagged [2004]; 1.2.3, 1.2.4 and 1.2.8 are tagged [2019]; 1.4.5 is tagged [2004, amended 2019]; 1.4.20 is tagged [2019, amended 2022]. Which edition of each recommendation these tags point to was not checked.",
            "reuse_basis": "Public text is cite_only (Ben's decision of 2026-10-13 (medical-atlas-core issue 2)): public pages state the facts in the atlas's own words, with a citation and a link, and use no NICE wording. NICE's terms and conditions (source cardio:nice-terms-and-conditions, fetched 2026-10-11) make NICE content available for reuse in the United Kingdom only. Outside the United Kingdom, apart from private use, study or one's own research, reuse needs NICE's prior written agreement, which may carry a licence and a fee, and use for artificial intelligence needs approval and a licensing arrangement. The terms also say NICE does not write its content as a basis for decisions outside the United Kingdom. The page bytes are not committed.",
            "public_text": "cite_only"
          }
        },
        {
          "evidence_role": "context",
          "locator": "Recommendation 1.2.4, version tag at the end",
          "applicability_note": "Dates the wording of the recommendation.",
          "snapshot": {
            "id": "cardio:nice-ng136-recs-2026-10-09",
            "retrieved_at": "2026-10-09T15:59:21Z",
            "content_hash": "68ce72f3487ffa4715f92ddfa8aaf6e093f5aecd3598cd59a0ab58f74ce86f28",
            "source_effective_date": "2026-02-26",
            "public_archive_url": null,
            "source_state": "current"
          },
          "source": {
            "id": "cardio:nice-ng136",
            "source_type": "guideline",
            "title": "Hypertension in adults: diagnosis and management (NICE guideline NG136), Recommendations chapter",
            "canonical_url": "https://www.nice.org.uk/guidance/ng136/chapter/Recommendations",
            "identifier_namespace": "nice",
            "identifier_value": "NG136",
            "publication_date": "2019-08-28",
            "publisher": "National Institute for Health and Care Excellence (NICE)",
            "edition": "The Recommendations chapter as shown on 2026-10-09 and fetched again on 2026-10-11 with identical bytes. The page header gives 26 February 2026 as the last update. This atlas cites six recommendations from it, each with the version tag the page shows: 1.1.3 is tagged [2004]; 1.2.3, 1.2.4 and 1.2.8 are tagged [2019]; 1.4.5 is tagged [2004, amended 2019]; 1.4.20 is tagged [2019, amended 2022]. Which edition of each recommendation these tags point to was not checked.",
            "reuse_basis": "Public text is cite_only (Ben's decision of 2026-10-13 (medical-atlas-core issue 2)): public pages state the facts in the atlas's own words, with a citation and a link, and use no NICE wording. NICE's terms and conditions (source cardio:nice-terms-and-conditions, fetched 2026-10-11) make NICE content available for reuse in the United Kingdom only. Outside the United Kingdom, apart from private use, study or one's own research, reuse needs NICE's prior written agreement, which may carry a licence and a fee, and use for artificial intelligence needs approval and a licensing arrangement. The terms also say NICE does not write its content as a basis for decisions outside the United Kingdom. The page bytes are not committed.",
            "public_text": "cite_only"
          }
        },
        {
          "evidence_role": "context",
          "locator": "Recommendations, introductory text, paragraph 3",
          "applicability_note": "Says the measuring and diagnosing recommendations apply to all adults.",
          "snapshot": {
            "id": "cardio:nice-ng136-recs-2026-10-09",
            "retrieved_at": "2026-10-09T15:59:21Z",
            "content_hash": "68ce72f3487ffa4715f92ddfa8aaf6e093f5aecd3598cd59a0ab58f74ce86f28",
            "source_effective_date": "2026-02-26",
            "public_archive_url": null,
            "source_state": "current"
          },
          "source": {
            "id": "cardio:nice-ng136",
            "source_type": "guideline",
            "title": "Hypertension in adults: diagnosis and management (NICE guideline NG136), Recommendations chapter",
            "canonical_url": "https://www.nice.org.uk/guidance/ng136/chapter/Recommendations",
            "identifier_namespace": "nice",
            "identifier_value": "NG136",
            "publication_date": "2019-08-28",
            "publisher": "National Institute for Health and Care Excellence (NICE)",
            "edition": "The Recommendations chapter as shown on 2026-10-09 and fetched again on 2026-10-11 with identical bytes. The page header gives 26 February 2026 as the last update. This atlas cites six recommendations from it, each with the version tag the page shows: 1.1.3 is tagged [2004]; 1.2.3, 1.2.4 and 1.2.8 are tagged [2019]; 1.4.5 is tagged [2004, amended 2019]; 1.4.20 is tagged [2019, amended 2022]. Which edition of each recommendation these tags point to was not checked.",
            "reuse_basis": "Public text is cite_only (Ben's decision of 2026-10-13 (medical-atlas-core issue 2)): public pages state the facts in the atlas's own words, with a citation and a link, and use no NICE wording. NICE's terms and conditions (source cardio:nice-terms-and-conditions, fetched 2026-10-11) make NICE content available for reuse in the United Kingdom only. Outside the United Kingdom, apart from private use, study or one's own research, reuse needs NICE's prior written agreement, which may carry a licence and a fee, and use for artificial intelligence needs approval and a licensing arrangement. The terms also say NICE does not write its content as a basis for decisions outside the United Kingdom. The page bytes are not committed.",
            "public_text": "cite_only"
          }
        },
        {
          "evidence_role": "context",
          "locator": "Using recommendations, paragraph 2",
          "applicability_note": "Explains the NICE convention for the word offer. It does not say how the convention applies to this recommendation.",
          "snapshot": {
            "id": "cardio:nice-making-decisions-2026-10-09",
            "retrieved_at": "2026-10-09T15:59:49Z",
            "content_hash": "b7838d1bdb692f2b6dfc71480aa95803d68c64aa0dde406375953c9479aaae7c",
            "source_effective_date": null,
            "public_archive_url": null,
            "source_state": "current"
          },
          "source": {
            "id": "cardio:nice-making-decisions",
            "source_type": "webpage",
            "title": "Making decisions using NICE guidelines",
            "canonical_url": "https://www.nice.org.uk/about/what-we-do/our-programmes/nice-guidance/nice-guidelines/making-decisions-using-nice-guidelines",
            "identifier_namespace": null,
            "identifier_value": null,
            "publication_date": null,
            "publisher": "National Institute for Health and Care Excellence (NICE)",
            "edition": null,
            "reuse_basis": "Public text is cite_only (Ben's decision of 2026-10-13 (medical-atlas-core issue 2)): public pages state the facts in the atlas's own words, with a citation and a link, and use no NICE wording. NICE's terms and conditions (source cardio:nice-terms-and-conditions, fetched 2026-10-11) make NICE content available for reuse in the United Kingdom only; outside it, apart from private use, study or one's own research, NICE's prior written agreement is needed.",
            "public_text": "cite_only"
          }
        },
        {
          "evidence_role": "context",
          "locator": "Clause 6, sentence 1",
          "applicability_note": "Source of the England audience read for this claim.",
          "snapshot": {
            "id": "cardio:nice-terms-and-conditions-2026-10-11",
            "retrieved_at": "2026-10-11T19:11:33Z",
            "content_hash": "663d4a4be632810ae88513ec6386193a7b373159e5e2ecd4ec61419e2e4c408a",
            "source_effective_date": null,
            "public_archive_url": null,
            "source_state": "current"
          },
          "source": {
            "id": "cardio:nice-terms-and-conditions",
            "source_type": "webpage",
            "title": "NICE terms and conditions, including the Notice of Rights",
            "canonical_url": "https://www.nice.org.uk/terms-and-conditions",
            "identifier_namespace": null,
            "identifier_value": null,
            "publication_date": null,
            "publisher": "National Institute for Health and Care Excellence (NICE)",
            "edition": "The page as fetched on 2026-10-11. It shows no version date; its footer carries the year 2026.",
            "reuse_basis": "Public text is cite_only (Ben's decision of 2026-10-13 (medical-atlas-core issue 2)): public pages state the facts in the atlas's own words, with a citation and a link, and use no NICE wording. This page sets the terms under which NICE content may be reused; its wording is kept in research/cluster-b/quotes.tsv as internal evidence and is not published. The page bytes are not committed.",
            "public_text": "cite_only"
          }
        },
        {
          "evidence_role": "context",
          "locator": "Clause 8",
          "applicability_note": "Source of the United Kingdom reliance limit read for this claim.",
          "snapshot": {
            "id": "cardio:nice-terms-and-conditions-2026-10-11",
            "retrieved_at": "2026-10-11T19:11:33Z",
            "content_hash": "663d4a4be632810ae88513ec6386193a7b373159e5e2ecd4ec61419e2e4c408a",
            "source_effective_date": null,
            "public_archive_url": null,
            "source_state": "current"
          },
          "source": {
            "id": "cardio:nice-terms-and-conditions",
            "source_type": "webpage",
            "title": "NICE terms and conditions, including the Notice of Rights",
            "canonical_url": "https://www.nice.org.uk/terms-and-conditions",
            "identifier_namespace": null,
            "identifier_value": null,
            "publication_date": null,
            "publisher": "National Institute for Health and Care Excellence (NICE)",
            "edition": "The page as fetched on 2026-10-11. It shows no version date; its footer carries the year 2026.",
            "reuse_basis": "Public text is cite_only (Ben's decision of 2026-10-13 (medical-atlas-core issue 2)): public pages state the facts in the atlas's own words, with a citation and a link, and use no NICE wording. This page sets the terms under which NICE content may be reused; its wording is kept in research/cluster-b/quotes.tsv as internal evidence and is not published. The page bytes are not committed.",
            "public_text": "cite_only"
          }
        }
      ],
      "review": {
        "content_digest": "ac510e2ad257b8502e7b0dcc6875f00d12a4f97de39174cc0c250c1393c0259b",
        "current": [],
        "conflicting": [],
        "stale": [],
        "inactive": []
      },
      "api_path": "api/v1/claims/cardio--claim-nice-ng136-1-2-4.json"
    }
  ],
  "decisions": [
    {
      "type": "recommendation",
      "id": "cardio:rec-nice-ng136-1-2-4",
      "direction": "for",
      "intervention_id": "core:home-bp-monitoring",
      "context_id": "cardio:ctx-nice-adults-suspected-hypertension",
      "guideline_snapshot_id": "cardio:nice-ng136-recs-2026-10-09",
      "issuer_id": "cardio:nice",
      "jurisdiction": "England, from clause 6 of the NICE terms and conditions, which presents the information as support for people in England who make decisions about funding care. Clause 8 adds that NICE does not write its content as a basis for decisions outside the United Kingdom. The NG136 page itself states no jurisdiction.",
      "strength_label": "Not labeled on the fetched page. The recommendation uses the verb offer.",
      "strength_system": "NICE wording convention. NICE says it uses the verb offer where the evidence of benefit is strong and leaves little doubt, and the verb consider where the benefit is less certain. How NICE applied this to the recommendation was not verified.",
      "effective_date": "2019-08-28",
      "effective_date_note": "The date NG136 was first published. The recommendation is tagged with 2019, and the page shows a last update of 26 February 2026.",
      "superseded_by": null,
      "supersession_status": null,
      "claim_id": "cardio:claim-nice-ng136-1-2-4"
    }
  ],
  "relationships": {
    "outgoing": [
      {
        "predicate": "recommended_for",
        "label": "NICE NG136 1.2.4: if ABPM is unsuitable or not tolerated",
        "clinical_claim_not_fact": true,
        "other_entity_id": "core:hypertension",
        "other_entity_in_atlas": true,
        "claim_id": "cardio:claim-nice-ng136-1-2-4"
      },
      {
        "predicate": "measures",
        "label": "Measures blood pressure at home",
        "clinical_claim_not_fact": false,
        "other_entity_id": "core:blood-pressure",
        "other_entity_in_atlas": true,
        "claim_id": null
      }
    ],
    "incoming": []
  },
  "page_path": "interventions/home-bp-monitoring/",
  "context_path": "api/v1/context/core--home-bp-monitoring.md"
}