The 21st-century version of the standard doctor’s advice may be “take your blood pressure twice a day and call or e-mail me in the morning.” As our collective blood pressure keeps rising and more and more research affirms the benefit of at-home monitoring to better manage hypertension, patients are being instructed to keep close track of their own highs and lows. According to new guidelines from the American Heart Association, the American Society of Hypertension and the Preventive Cardiovascular Nurses’ Association, most Americans with known or suspected hypertension (74 million adults, at least) should take regular blood pressure readings at home — especially those with high blood pressure of 140/90 mm Hg or higher. Not only will this help keep hypertension in check, but it also may be the only accurate way to get measurements for people who suffer from what’s come to be known as “white coat hypertension,” where the mere fact that a health care professional is checking makes blood pressure soar.
Why the big push for home blood pressure monitoring? I spoke with hypertension and vascular specialist Mark C. Houston, MD, author of What Your Doctor May Not Tell You About Hypertension: The Revolutionary Nutrition and Lifestyle Program to Help Fight High Blood Pressure, for details.
By providing a more accurate representation of day-to-day rises and falls, home monitoring can confirm suspected or newly diagnosed hypertension or it can be used to evaluate and fine-tune your response to antihypertensive treatment. Continuous monitoring may also be valuable for people with borderline or pre-hypertension (between 120/80 and 139/89), as it can help determine whether to initiate treatment and at what level.
The two most common types of home monitors are aneroid and digital. Aneroid monitors are the old-fashioned ones that have a stethoscope, a bulb you pump to inflate, a cuff and a gauge. Digital monitors are more convenient and easier to use on yourself, with built-in sensors and easy-to-read number displays, plus most automatically inflate and deflate. According to Dr. Houston, the arm monitors are the most accurate. Although wrist and finger versions are also available, Dr. Houston does not recommend using them.
Those who are instructed to begin home monitoring should do it twice daily, as close to the same time as you can — once in the morning, before you take medication, and again in the evening. If you plan to exercise or drink anything with caffeine — or have a cigarette, which you shouldn’t be doing anyway — take your blood pressure first. Also, make sure to sit quietly for five minutes before taking a reading.
Monitors are widely available at pharmacies, medical supply stores and online. Prices vary from about $30 to over $100, depending on options (e.g., memory recall that allows you to view blood pressure history, built-in printers and a USB cable or AC adapter to hook up to a computer to transmit data directly to your doctor’s office). Dr. Houston likes those by Omron (www.omronhealthcare.com).
Whatever monitor you choose, make sure your doctor sees and approves it and also tests it against what’s used in the office. Ask for some training in proper use as well. Establish in advance what type of reading merits a phone call or visit.
It may require a little extra work, but home blood pressure monitoring can pay off with a lower risk of serious complications and greater piece of mind.
