9/18/2013 12:23:00 PM Monitoring blood pressure can be easily done at home
DEAR DOCTOR K: I have hypertension. Should I be monitoring my blood pressure at home?
DEAR READER: You bet. It's easy and inexpensive, and provides you and your doctor the information you need to protect your health.
About one in three adults in the United States has high blood pressure, or hypertension. And about half of those with high blood pressure don't have it under control. Hypertension increases the risk for heart disease and stroke. In my opinion, hypertension may be the most important public health problem in the United States, as it affects so many people. Recognizing and treating it brings enormous health benefits.
You always have a blood pressure, every minute of the night and day, and it can change a lot from one moment to the next. What matters most to your health is where your blood pressure is on average. Before we had home blood pressure monitoring machines, the way a doctor determined if your blood pressure was controlled was to have you make a trip to his or her office.
If you think about it, that's pretty silly. The doctor is supposed to estimate what your average blood pressure is all day and all night based on one visit to the doctor's office every several months. And since many people get nervous when they visit the doctor -- yes, even my patients -- the reading in the office may not be representative. Home blood pressure machines make it easy to get a much better estimate of what your average blood pressure really is.
The latest evidence for the benefits of home blood pressure monitoring comes from researchers who studied 450 people with hypertension. About half were given home blood pressure monitors that electronically sent readings to a secure website. The volunteers were asked to send six readings each week. Pharmacists analyzed that information and adjusted medications if needed or offered advice on lifestyle changes to lower blood pressure. The other volunteers received usual care from their primary care providers.
At every step of the way, people in the home monitoring group had more success getting their blood pressure under control. The benefits persisted six months after the program had ended.
You can buy a good home blood pressure monitor for under $100. Look for:
-- an automatic monitor that doesn't require a stethoscope (it's easier to use);
-- a monitor that takes the blood pressure reading using a cuff that fits around the upper arm;
-- a read-out large enough for you to see the numbers;
-- a seal of approval from a trusted organization.
Ask your doctor, nurse or pharmacist for help in calibrating your monitor and learning how to use it. (On my website, AskDoctorK.com, I've posted a video showing the correct way to use a home blood pressure monitor.)
Also ask how often you should check your blood pressure, and share the results of your readings with your doctor. Finally, remember that home monitoring is not a substitute for regular physician checkups.
(Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.)