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According to the American Heart Association (AHA), more than 100 million Americans suffer from high blood pressure, but only half of them control it.
Now, preliminary research suggests that adopting a simple measure – home blood pressure monitoring – can improve these prospects, helping many more people with uncontrolled hypertension to control it. .
When high blood pressure is not under control, patients are at high risk of heart attack, brain aneurysm or stroke. And while previous studies have shown that a home blood pressure monitor can be very effective, only about one-third of people with hypertension check their blood pressure at least once a month, according to the Centers for Disease Control and Prevention.
"The average doctor tries to see a patient every 10 to 15 minutes, so it's barely time to review the drugs, let alone monitor blood pressure at home," says Roy Champion, M.Sc. Scott and White Health Plan in Temple, Texas, who presented the new research at an AHA conference.
Here, what you need to know about new discoveries and what you need to consider if you are thinking about trying to monitor your own blood pressure at home.
What new research has found
Researchers provided free home blood pressure monitors, surveillance reminders and resources to take and monitor readings to 2,550 adults with uncontrolled hypertension and monitored patient progress between December 2016 and June 2017.
At the third visit, more than two-thirds of patients (nearly 67%) had controlled blood pressure. An even larger proportion of patients still had their blood pressure under control by the end of 2017.
"Doctors have been able to adjust patients' blood pressure medication upwards or downwards based on the information provided by home monitoring, so that they are at the most appropriate dose," explains Champion.
At the end of the study, subjects' systolic blood pressure (the highest number) had decreased by 16.9 mmHg on average and diastolic blood pressure (lower number) by 6.5 mmHg on average.
But if the results were spectacular, it was a pilot observational study that has not yet been peer reviewed and there was no control group. All of this means that it is too early to say whether the results would apply to the entire population.
"Patients who have agreed to participate in this study and who are doing home-based surveillance may have been more motivated and would have had better results," says Swapnil Hiremath, MD, MPH, hypertension specialist and assistant professor of medicine at University of Ottawa.
However, "giving patients the means to access their own blood pressure numbers is most likely more effective than a five to ten minute visit to the doctor," he says. "Many patients are reluctant to take blood pressure medications and stick to them, because hypertension is a silent disease. They feel good, so in their minds they are fine. But when they see these numbers go up when they miss a dose or eat a high-fat, salty meal, they are strongly encouraged to follow their diet and adopt healthy lifestyle changes.
(To learn more about who needs blood pressure medications and why you should first try lifestyle changes, check out our previous coverage.)
Who needs a blood pressure monitor?
Although groups like the AHA and the American College of Cardiology have long been recommending home blood pressure monitoring for patients with hypertension, other simple strategies include: self-test, such as home blood glucose testing, notes Luke Laffin, MD, a preventive cardiologist at Cleveland Clinic.
This may be because it takes time and the instructors themselves, who are not covered by insurance, can be expensive. They do not have to be: Consumer Reports has recommended models for as little as $ 29. According to Champion, participants in the new study also had fewer doctor visits and fewer ERs and medications after regularly using a home monitor.
While people with hypertension should consider a home monitor, says Laffin, it is especially important for the following patient groups:
About 12% of American adults suffer from a condition called masked hypertension, where their blood pressure is normal in the doctor's office but raised at home. So, if you have not diagnosed high blood pressure, but your results are at the limit in the doctor's office, you can still consider investing in a home monitor.
Periodic checking of a home monitor for a few weeks can be helpful in these cases, says Hiremath.
How to choose a blood pressure monitor
Consumer Reports has a buying guide that explains the different types of sphygmomanometers and what you need to know before you buy one.
Home sphygmomanometers come with armbands, wrists and finger models. The cuff patterns are the most reliable of the three, says Laffin. (Finger patterns should be completely avoided because they calculate your blood pressure by looking at the blood flow in your finger, which can be very imprecise.)
You can choose a higher scoring model by using our blood pressure assessments. It is important to make sure the monitor is the right size: the cuff (usually two) should fit around the arm circumference. If it is too big or too small, it can lead to inaccurate readings.
When you buy one, it is important to choose one that gets high marks for accuracy. The CR testers compare the BP reading of each model to the BP reading on a machine long considered the gold standard. You should also test your new machine in your doctor's office to make sure you are using it properly and getting consistent results.
A study conducted in 2016 by Hiremath revealed that nearly a third of home blood pressure monitors had been eliminated from at least 5 points. Another study, published in 2017, suggested that problems of inaccuracy could be even more prevalent.
Inaccurate readings can lead to dangerous miscalculations, warns Champion. Plan to bring your monitor to the doctor's office at least once a year to make sure it is still working properly, and never adjust your medication or treatment plan without consulting your doctor.
How to check your own blood pressure
Some precautions can help you get the most accurate reading possible:
If you get a good read, do not panic, says Hiremath. Wait five minutes, then test again.
If reading is only slightly higher than normal, take your blood pressure a few more times during the day and tell your doctor if she is still high.
But if your blood pressure readings are above 180/120 mmHg, call your doctor right away, as this could mean a high blood pressure crisis. (If you also have symptoms such as chest pain, shortness of breath, or back pain, dial 9-1-1.)
Also, if your blood pressure is abnormally low, call your doctor, especially if you have symptoms such as feelings of weakness and dizziness. This can be a sign that you need to reduce your dose of medication.
Regardless, every time you take your blood pressure, be sure to record your results, either on paper or using an online tracking tool (some monitors also have built-in memory for storing readings). Then share what you recorded with your doctor at your next appointment.
These results can help your doctor make the most informed decisions about your medications and the treatment plan needed, says Dr. Hiremath, and can help determine whether high office reading is a case of high blood pressure or a constant problem.
Choice of products
Consider these recommended blood pressure monitors from Consumer Reports tests. Click on the maps below to access the model page of each device, where you will find more information about products and purchases.
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- Anyone who is taking medication for high blood pressure, to make sure that they are at the right dose.
- Patients with other coexisting conditions such as type 2 diabetes or kidney disease.
- Pregnant women who develop signs of hypertension or pre-eclampsia.
- People who have had high or low readings in the doctor's office, but must confirm that they have true hypertension.
- People who may have "white blood pressure", a condition where their blood pressure is normal at home, but high when they are nervous in a doctor.
- Try to take your blood pressure at the same time each day. The levels are usually the lowest in the morning and increase steadily throughout the day.
- Do not exercise, do not smoke and do not consume caffeine for at least an hour before.
- Keep calm. Talking can increase your blood pressure.
- Go to the bathroom just before, because a full bladder can increase your systolic pressure by 15 points and your diastolic by 10 points.
- Make sure your feet are flat on the floor, legs uncrossed and the cuff at the level of the heart.
- Place the cuff on bare skin, as putting it on clothing can increase your systolic pressure by up to 50 mmHg.
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