Home Blood Pressure Tests Predict Risk Better
At-Home Blood Pressure Monitoring May Reveal Hidden Heart Risks
March 16, 2004 -- Home blood pressure tests may be a better predictor of heart disease or stroke risk than those performed at the doctor's office, a new study suggests.
French researchers found home blood pressure measurements taken among a group of elderly men and women with high blood pressure more accurately identified those patients at risk for future heart attack and stroke than tests taken in the office.
Researchers say the results suggest that blood pressure should be measured at home as well as at the doctor's office among people being treated for high blood pressure.
Home Blood Pressure Tests Reveal Risks
In the study, researchers compared the predictive value of home vs. office blood pressure measurements in a group of more than 4,900 elderly patients being treated for high blood pressure.
After about three years, the study showed that 324 patients had suffered a heart problem, such as having a heart attack or stroke or needing heart bypass surgery.
Researchers found that each 10-point increase in the patient's at-home systolic blood pressure (the top number) reading increased the risk of heart disease and stroke by 17%. Each five-point increase in at-home diastolic blood pressure (the bottom number) increased that risk by 12%.
But neither office systolic nor diastolic blood pressure had the same predictive value.
In this elderly population, office blood pressure measurements failed to identify 9% of those with elevated blood pressure at home but not in the office, write Guillaume Bobrie, MD, of the HÃ´pital EuropÃ©en Georges Pomipdou, and colleagues. This is particularly concerning because the frequency of heart events or stroke in this group is similar to that of patients who don't have their blood pressure under control.
These findings suggest that the monitoring of patients being treated for high blood pressure must include home blood pressure self-measurement, which is the method most preferred by patients, they write.
But researchers say more study is needed to determine if changing treatment based on home blood pressure monitoring will help prevent heart disease or stroke. Until then, they say treatment and follow-up of patients with elevated blood pressure at home but not in the office need to be studied.