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Add to To-Do List: Check Blood Pressure

Older Folks, People With High Blood Pressure, Diabetes Should Monitor Blood Pressure at Home
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WebMD Health News

May 22, 2008 -- You know your blood pressure, right?

Most people have their blood pressure checked at the doctor's office or the pharmacy. But if yours is high or borderline high, if you are in your 70s or older, or if you have diabetes or kidney disease, you may want to start checking your blood pressure at home. That's according to a new statement issued by the American Heart Association and two other groups.

Because blood pressure can vary so much, the groups advise that it's more accurate to check your own levels every day or so, instead of at a doctor's office every few months.

"High blood pressure is notoriously difficult to treat. ... Many patients fail to reach target levels despite treatment," Thomas Pickering, MD, DPhil, assistant professor of medicine at Columbia University, says in a news release.

Pickering says "studies show home monitoring can help" track blood pressure levels in the same way that blood sugar monitors help people with diabetes track their blood sugar levels.

Sometimes, home blood pressure monitoring can show that there is actually no blood pressure problem at all. Studies have shown that between 10% and 20% of patients diagnosed with high blood pressure in a doctor's office actually have what is called "white coat hypertension." That means their blood pressures are normal but rise only when in a hospital or doctor's office.

At-Home Blood Pressure Monitoring

Who should monitor blood pressure levels at home?

  • People with high blood pressure or suspected high blood pressure
  • People with diabetes
  • People over age 70
  • Pregnant women
  • People with kidney disease

Here are some guidelines to follow when measuring your blood pressure at home:

  • Do not smoke or take caffeine 30 minutes before measuring.
  • Rest for five minutes.
  • Keep your arm at heart level, support your back, and keep your feet flat on the ground.
  • If you are right-handed, put the device on your left arm (and vice versa), or consistently take the measurement in the arm with the higher pressures.
  • Take two to three measurements in the morning and two to three in the evening every day and keep a log of your readings.
  • For long-term monitoring, checking your levels daily for one week every three months should suffice.

Your target blood pressure goal should be 135/85, or 130/80 if you have diabetes, heart disease, or chronic kidney disease.

Buying a Blood Pressure Monitor

Getting a home blood pressure device:

  • The devices can be purchased for less than $100.
  • Buy an oscillometric monitor (these are mostly automatic monitors that display blood pressure readings on a screen) with a well-fitting upper-arm cuff.
  • Wrist monitors are not recommended.
  • Once you have purchased the monitor, bring it with you to your next clinic visit so you can check your technique and the accuracy of your monitor.

The groups recommend only buying devices that meet the standards set by either the Association for the Advancement of Medical Instrumentation (AAMI) or the British Hypertension Society (BHS).

In prepared statements, Pickering says he hopes the recommendations will prompt people to use home monitors and usher in a "new era in patient and doctor partnerships," adding "it really does depend on the patients remembering to change their lifestyles or remembering to take their pills."

The recommendations are from the American Heart Association, American Society of Hypertension, and the Preventive Cardiovascular Nurses' Association.

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