People with high blood pressure should monitor it regularly at home to get truer readings than those sometimes taken in a doctor’s office and better manage the condition, experts urged on Thursday.
The recommendations issued by the American Heart Association and two other groups aim in part to get around the “white coat effect” in which some people’s blood pressure rises simply due to the stress of being in a doctor’s office.
High blood pressure, also known as hypertension, is on the rise in the United States and other developed nations, fueled by rising obesity and sedentary lifestyles. It can lead to heart attack, heart failure, stroke and kidney failure.
The American Society of Hypertension and the Preventive Cardiovascular Nurses’ Association joined the American Heart Association in urging people with high blood pressure to use commercially available home blood pressure monitoring devices.
“Only a third of people who have high blood pressure have it controlled. The belief is that the use of these monitors will help a larger percentage of people get better control of their blood pressure,” American Heart Association President Dr. Daniel Jones said in a telephone interview.
Because blood pressure fluctuates during the day, a reading at a doctor’s office every few months may not provide a true assessment of a person’s condition, the groups said.
“In the medical-care environment, the patient can become anxious or nervous. And they actually have a much higher pressure artificially only in the medical-care environment that doesn’t exist elsewhere,” Dr. William White of the University of Connecticut School of Medicine, a American Society of Hypertension board member, said in a telephone interview.
“It exists in about one out of three people whether they’re on treatment or not,” added White, who also noted that conversely, some people have higher blood pressure outside the medical setting - for example, at a stressful workplace.
Many home blood pressure monitoring devices cost less than $100, the groups said. People should use oscillometric monitors with cuffs that fit on the upper arm, the groups said. They did not recommend the use of wrist or finger monitors.
People should take two or three blood pressure readings a minute apart while in a seated position, both in the morning and at night, over a period of a week, the groups said.
Home monitoring was especially recommended for older people who may be more likely to experience the “white coat effect,” pregnant women and people with diabetes or kidney disease.
Tracking one’s own blood pressure at home is akin to diabetics tracking their condition by monitoring their blood sugar levels with home glucose monitors, the groups said.
Some common hypertension risk factors include: being overweight, being sedentary, having too much salt in the diet, smoking, stress, low potassium intake and too much alcohol.
Medications, exercise, changes in diet and weight loss are among the ways to reduce high blood pressure.
Blood pressure readings are measured in millimeters of mercury (mmHg) and are stated as two numbers.
The top number is the pressure created when the heart beats, known as systolic pressure, and is deemed high if it is consistently over 140. The bottom number is the pressure inside blood vessels when the heart is at rest, known as diastolic pressure, and is deemed as high if it is consistently over 90.
By Will Dunham