High blood pressure patients advised to use home monitors

May 22, 2008

DALLAS, May 22 -- People with hypertension should routinely monitor their blood pressure at home to help manage the disease, according to a new joint scientific statement from the American Heart Association, American Society of Hypertension and the Preventive Cardiovascular Nurses' Association.

The statement is published online in Hypertension: Journal of the American Heart Association, the Journal of the American Society of Hypertension and the Journal of Clinical Hypertension and printed in the June issue of Journal of Cardiovascular Nursing.

"High blood pressure is notoriously difficult to treat to goal - many patients fail to reach target levels despite treatment, and studies show home monitoring can help," said Thomas G. Pickering, M.D., D.Phil., chair of the statement writing group. "Blood pressure measurement and tracking could be improved with home monitoring by the patients themselves, in much the way people with diabetes monitor their blood sugar levels with home glucose monitors."

He said there is strong evidence that the traditional way of measuring blood pressure in adults can be misleading. Studies indicate that between 10 percent and 20 percent of people diagnosed with high blood pressure in the doctor's office actually have the 'white coat effect,' meaning that their pressures are normal under other conditions, but rise in the medical setting.

"It is also believed that some people with normal blood pressures in their doctors' offices have pressures that spike to potentially dangerous levels in other situations," said Pickering, director of the Center for Behavioral Cardiovascular Health at Columbia Presbyterian Medical Center in New York, N.Y.

According to the statement, home monitoring is particularly useful in the elderly, in whom both blood pressure variability and the white coat effect are increased, as well as in patients with diabetes, patients with kidney disease and in pregnant women.

Pickering noted that because everyone's blood pressure is highly variable during the day, taking one reading at a doctor's office every few months doesn't give a complete picture of a person's condition. Home monitors can take multiple measurements during each session, and can be used at different times of day. Many monitors also store and average blood pressure readings over time, providing crucial data for patients to take to their physicians so they can work as a team to diagnose and treat the condition. Many types of home monitors are relatively inexpensive at less than $100.

"Home blood pressure monitoring also gives patients the physiologic feedback they need to see regarding blood pressure," says Nancy Houston Miller, R.N., co-author and former president of the Preventive Cardiovascular Nurses Association. "Rather than three to four office blood pressure checks per year, if they measure blood pressure at home in addition to following up with their healthcare provider, patients are likely to achieve goals more quickly and be confident that medicines are working for them." She also states that nurses and nurse practitioners have a significant role to play in interpreting data from blood pressure devices and educating patients about needed lifestyle interventions and medications.

"We're encouraged by this joint statement on the value of home blood pressure monitoring and confident it will be helpful in reducing the incidence of heart attack, stroke and kidney disease," said Suzanne Oparil, M.D., president of the American Society of Hypertension.

Hypertension increases the risk of heart attack and stroke and controlling it is essential to reducing that risk. The statement writing group said home blood pressure monitoring is evidence-based healthcare that can improve the quality and lower the cost of caring for the 73 million people with hypertension.

Although earlier American Heart Association guidelines have included home monitors, this is the first statement to have detailed recommendations on their use. "I hope this leads to a new era in patient-doctor partnerships," Pickering said. "I think this is a very healthy trend and with a condition like high blood pressure, it really does depend on the patients remembering to change their lifestyles or remembering to take their pills."

Only a few of the home blood pressure devices on the market have been subjected to proper validation tests such as the Association for the Advancement of Medical Instrumentation (AAMI) and British Hypertension Society (BHS) protocols. Several devices have failed the tests. An up-to-date list of validated monitors is available on the BHS Web site, http://www.bhsoc.org/default.stm.
Co-authors include Gbenga Ogedegbe, M.D., M.P.H.; Lawrence R. Krakoff, M.D.; Nancy T. Artinian, Ph.D., R.N.; and David Goff, M.D., Ph.D.

American Heart Association

Related Blood Pressure Articles from Brightsurf:

Children who take steroids at increased risk for diabetes, high blood pressure, blood clots
Children who take oral steroids to treat asthma or autoimmune diseases have an increased risk of diabetes, high blood pressure, and blood clots, according to Rutgers researchers.

High blood pressure treatment linked to less risk for drop in blood pressure upon standing
Treatment to lower blood pressure did not increase and may decrease the risk of extreme drops in blood pressure upon standing from a sitting position.

Changes in blood pressure control over 2 decades among US adults with high blood pressure
National survey data were used to examine how blood pressure control changed overall among U.S. adults with high blood pressure between 1999-2000 and 2017-2018 and by age, race, insurance type and access to health care.

Transient increase in blood pressure promotes some blood vessel growth
Blood vessels are the body's transportation system, carrying oxygen and nutrients to cells and whisking away waste.

Effect of reducing blood pressure medications on blood pressure control in older adults
Whether the amount of blood pressure medications taken by older adults could be reduced safely and without a significant change in short-term blood pressure control was the objective of this randomized clinical trial that included 534 adults 80 and older.

Brain blood flow sensor discovery could aid treatments for high blood pressure & dementia
A study led by researchers at UCL has discovered the mechanism that allows the brain to monitor its own blood supply, a finding in rats which may help to find new treatments for human conditions including hypertension (high blood pressure) and dementia.

Here's something that will raise your blood pressure
The apelin receptor (APJ) has been presumed to play an important role in the contraction of blood vessels involved in blood pressure regulation.

New strategy for treating high blood pressure
The key to treating blood pressure might lie in people who are 'resistant' to developing high blood pressure even when they eat high salt diets, shows new research published today in Experimental Physiology.

Arm cuff blood pressure measurements may fall short for predicting heart disease risk in some people with resistant high blood pressure
A measurement of central blood pressure in people with difficult-to-treat high blood pressure could help reduce risk of heart disease better than traditional arm cuff readings for some patients, according to preliminary research presented at the American Heart Association's Hypertension 2019 Scientific Sessions.

Heating pads may lower blood pressure in people with high blood pressure when lying down
In people with supine hypertension due to autonomic failure, a condition that increases blood pressure when lying down, overnight heat therapy significantly decreased systolic blood pressure compared to a placebo.

Read More: Blood Pressure News and Blood Pressure Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.