New Advice to Monitor Blood Pressure at Home

New Advice to Monitor Blood Pressure at Home

More than 100 million Americans should monitor their blood pressure at home, according to new recommendations. About 72 million people have hypertension—defined as a reading of greater than 140 over 90—and an additional 25 million have prehypertension, which is a reading higher than 120/80 but below 140/90. The recommendations are published online in Hypertension: Journal of the American Heart Association, the Journal of the American Society of Hypertension, and the Journal of Clinical Hypertension, as well as in the June issue of Journal of Cardiovascular Nursing.


People who have been diagnosed with hypertension (high blood pressure) should be especially vigilant in monitoring their blood pressure. But just because you haven't been diagnosed with high blood pressure does not mean you're not at risk. Men between the ages of 18 to 34 are the least likely to be aware of having high blood pressure.

Blood pressure varies during the day, just like blood sugar. Only by knowing your pattern can you deal effectively with it. You can’t learn your pattern in your doctor’s office. You need to check it yourself, and monitor it over time.

People should use blood pressure monitors that have cuffs for the upper arm, and they should take two or three readings at a time—about one minute apart—while in a seated position. The person's arm should be supported, and the upper arm should be located at heart level, with feet on the floor.

Recently, a study found that high blood pressure is still slipping past doctors. Learn more about the condition on the U.S. News Hypertension Channel. High blood pressure is a leading cause of heart attacks, strokes and death. Having it checked a few times a year in a doctor's office or at the drugstore is not enough to keep tabs on it, and regular home monitoring is more accurate, the new advice says.

This months "My Blood Pressure Newsletter" also includes a review of a clinical study which investigates whether, ‘home monitoring can give better blood pressure control?’ This is an interesting question for those looking to reduce and manage their high blood pressure.

The researchers compared the blood pressure control of those who home monitor with those that had their blood pressure taken in a doctors office. The results of the study were so overwhelming that the researchers concluded, “Our findings imply that it is important that physicians recommend home BP measurement to their patients.”

Related study by University of Michigan:

Blood pressure and hypertension are an issue for diabetic patients as they have an increasing need to receive adequate treatment for blood pressure, study shows.

But a new study finds that even when people with diabetes show up in their doctor's office with a high blood pressure reading, there's only a 50-50 chance that each of them will get some sort of attention for it. That might mean a change to their medications, or a plan to follow up a few weeks later to see if the reading is still high.

More systematic guidelines for monitoring blood pressure in people with diabetes, and better guidance for when to change treatment when pressures get too high, are needed, say the researchers. They're led by Eve Kerr, M.D., MPH, and Timothy Hofer, M.D., M.S., of the Center for Clinical Management Research at the VA Ann Arbor Healthcare System and U-M Medical School's Division of General Medicine.

"Providers clearly 'trust' their own reading more than they do the reading taken at the clinic intake point," suggests Hofer. "But there is no evidence that supports that approach. In fact, the literature suggests that provider measurements are less reliable and subject to large biases relative to independent measures by nurses using electronic blood pressure cuffs."

Additionally providers responded to their patient's own report about what kind of readings he or she was getting using a home blood pressure monitor. Only 18 percent of patients who told their providers their home measurements had been below 140/90 mm Hg received a treatment change, compared with 52 percent who said their pressures at home had been high, or who didn't report at-home monitoring.

While at-home monitoring can be important, Kerr says, the fact of the matter is that there is no standard for how often to monitor and how to record home pressure readings over time. Further, patients might preferentially report only the "normal" blood pressures and ignore the out-of-range values.

Patients should talk to their doctors about how often to monitor and record their blood pressure and look at averages over time, she says. If their average is above the target, it might be time to change treatment.

"When you measure your blood pressure at home it helps you and your doctor understand how well your blood pressure is controlled on a day-to-day basis," says Dr. Arun Chockalingam, secretary general of the World Hypertension League (WHL). "The only way to know if your blood pressure is high is to measure...so measure at home in addition to periodic evaluation of blood pressure by a doctor or other health professional."

WHL goal is to bring together and stimulate organizations committed to the control of hypertension. The WHL is a division of the International Society of Hypertension (ISH), and is in official relations with the World Health Organization (WHO).

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