Ambulatory BP monitoring to be Medicare funded

The Budget announcement of $40.5 million for Medicare listing of ambulatory blood pressure monitoring (ABPM) has been welcomed by the High Blood Pressure Research Council of Australia.

The new MBS item is scheduled to commence on 1 November 2021, and will cover diagnosis of hypertension using ABPM in patients with clinic blood pressure ≥140/90 mmHg and ≤180/110 mmHg “on the basis that ABPM is the accepted gold standard for the diagnosis of high blood pressure in primary care.”

The funding was approved by the Medicare Services Advisory Committee in 2020 in response to an application from a HBPRCA Executive Subcommittee chaired by Professor Geoffrey Head and endorsed by CSANZ.

“The listing of ABPM on the MBS is an important step forward in the management of this condition that affects approximately one third of adult Australians … and brings Australia in line with the rest of the world,” the HBPRC said in its response.

“The outcome highlights the importance of ‘out of office’ blood pressure measurement and considerable gaps in effectively diagnosing and treating high blood pressure

FFR vs angiography strategies compared in MI

Complete revascularisation that is guided by fractional flow reserve (FFR) is not superior to an angiography-guided procedure for patients with STEMI and multivessel disease who have undergone successful PCI of the infarct-related artery, a European study has found.

Results of a multicentre trial involving 1163 patients showed there was no difference between the two strategies in terms of reducing the risk of the primary outcome of death, myocardial infarction, or urgent revascularisation at one year.

However, there were wide confidence intervals for the estimate of effect, said the authors of the Flow Evaluation to Guide Revascularisation in Multivessel ST-Elevation Myocardial Infarction (FLOWER-MI) study published in NEJM.

DOACs have fewer drug interactions than warfarin

Patients who switch from warfarin to DOACs have fewer potential drug interactions, an Australian study has found. A review of 712 patients with atrial fibrillation stopped warfarin to start apixaban or rivaroxaban found that the proportion of patients with no potential drug interactions increased from 47% to 63%. Similarly, the proportion of patients taking one medication with an anticoagulant drug interaction was lower with DOACs compared (29% vs 35%), researchers from Griffith University, Queensland found.

More information: Journal of Thrombosis and Thrombolysis