Monitoring Blood Pressure at Home Goes High Tech
May 23, 2001 (San Francisco) -- About 50 million Americans have high blood pressure, but most of them will never get their blood pressure down to the healthy level that experts say will reduce their risk for heart attack, stroke, and diabetes. Well, maybe up until now.
A new technology that offers patients a way to "phone it in" may finally rein in this risk factor.
Thomas G. Pickering, MD, discussed the new technology with high blood pressure experts attending the 16th annual meeting of the American Society of Hypertension.
Pickering, a professor of medicine at Mt. Sinai Medical School in New York, says that high blood pressure, or hypertension, remains a significant public health problem worldwide, a fact that often frustrates the experts. The frustration is fueled by the fact that although physicians know how to treat high blood pressure -- and have more than 100 medications to help them do so -- only about one-third of patients under a physician's care ever reach their target blood pressures
Doctors often blame patients for not making needed lifestyle changes -- stop smoking, lose weight, exercise, eat a healthy diet -- or for not taking their blood pressure medications as needed, says Pickering. Patients, on the other hand, often say that physicians set unrealistic lifestyle goals or prescribe drugs that have unpleasant side effects like cough or sexual dysfunction.
The mutual finger pointing, says Pickering, leaves both patients and physicians unhappy. Now technology is coming forward with a solution that can keep both sides happy and help patients actually reach a normal, healthy blood pressure, which is defined as less than 130/85.
It's called telephonic/electronic monitoring of blood pressure, and it works this way: Patients take their own blood pressures at home every morning and every evening. This isn't very different from home monitoring with blood pressure units available in discount stores. The difference, says Pickering, is that these units store the blood pressure readings in a special memory device that can be hooked up to a modem that downloads the readings to a central computer. The computer then generates a daily blood pressure report, which is faxed to the doctor's office.
The advantage, says Pickering, is in the accuracy of the readings.
"Traditionally, the patient comes into the doctor's office every few months and gets his or her blood pressure measured," he says. These readings are notoriously unreliable. "The measurement can be affected by so-called white coat hypertension in which the patient's blood pressure spikes when in the doctor's office, or it can also be lower that normal."
Many high blood pressure experts attempt to get around this by asking patients to use home monitors. "Then you get a patient who comes in with blood pressures written on the back of an envelope," he says. The accuracy of this method relies upon the patient's ability to remember to keep the record and their willingness "to write down all the measurements without leaving out measurements that the doctor may not like," he says.