Monitoring high blood pressure at home

Seven's On Call with Dr. Jay Adlersberg
May 21, 2008 9:00:00 PM PDT
High blood pressure can lead to serious health problems. Now, there are new recommendations on keeping a close eye on it.Seven's On Call with Dr. Jay Adlersberg.

If you are one of the 60 million Americans with high blood pressure, or hypertension as it is also called, listen up.

A number of medical groups, including the American Heart Association, are issuing a new recommendation which you may want to carry out at home.

Most people with high blood pressure have their numbers taken when they check in with their doctors.

Elizabeth Trafelet not only takes medication to control her high blood pressure, but also is now using a home monitor to keep track of it.

"When I went to see my physician, he recommended that it would be helpful to have a lot of different readings," she said. "So that he could get a really good understanding, sort of the trends of my blood pressure, how the medications were affecting it."

And what she does, all hypertension patients should do, according to the new recommendations from doctors' groups specializing in treating hypertension.

"It's becoming well recognized that the readings taken by the doctor aren't necessarily very representative of what the patient's blood pressure is at other times," said Dr. Thomas Pickering, of Columbia Presbyterian Medical Center.

Sometimes patients develop what is known as white coat hypertension, which means it spikes up when they're at the doctor's office.

The guidelines advise patients to speak to their doctors about whether they should do home monitoring. If so, a doctor should demonstrate how to properly use a home monitor and should calibrate it for accuracy.

Other directions include resting for five minutes before taking your blood pressure and sitting up straight with your feet flat on the floor as you take it. Doctors say take several readings, one minute apart, in the morning and again at night. Write down the results so you can keep track of them. Finally, be diligent, but don't become obsessive.

"When they get one high reading, they think, 'Ooh, I'd better take another,'" Dr. Pickering said. "And when they take it, it goes on getting higher and higher. And that's just because the anxiety builds up. So, we recommend that they only take two or three readings at a time and then stop."

Close monitoring of high blood pressure is important because hypertension increases a person's risk of heart attack and stroke. Home monitoring can encourage patients to get involved in their own care.

"There is evidence that people who monitor their blood pressure actually get better control of their blood pressure, probably because those who test their blood pressure are also more likely to remember to take their pills," Dr. Pickering said.

Dr. Pickering says home monitoring won't replace doctors' measurements, but it may become the standard method for monitoring blood pressure and can be very useful in improving the degree of blood pressure control in the general population.

Home blood pressure monitors do not work accurately for people with very irregular pulse beats or certain arrhythmias. Talk to your doctor about whether home monitoring is right for you.

The American Heart Association provides an array of free online information and tools to track and manage blood pressure. For more information, click here.

The site includes a link to the blood pressure management center within the Microsoft HealthVault, as well as online resources to help patients learn about risks for high blood pressure, how to monitor and manage high blood pressure and how to communicate with healthcare providers for effective treatment options.