High Blood Pressure Can be Diagnosed and Managed by Home Monitoring

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Highlights:

• Blood pressure levels of 130/80 mmHg or greater measured at home can be used to diagnose elevated blood pressure (hypertension) in white, black and Hispanic adults in the US
• Blood pressure readings made at home believed to reflect true values since, clinic readings may be affected by factors such as patient anxiety and apprehension (white coat hypertension)
• Risk of heart disease in persons with hypertension on home blood pressure monitoring similar to those with identical readings made in the clinic

Home blood pressure measurements can be used to diagnose and manage hypertension in white, black and Hispanic adults in the US, according to a recent study at UT Southwestern Medical Center in Dallas. The results of the study appear in the American Heart Association's journal Hypertension.

"Until now, recommendations for diagnosing high blood pressure with measurements done at home were primarily from Japanese and European studies," said Wanpen Vongpatanasin, M.D., study author, professor of medicine and hypertension director at UT Southwestern Medical Center in Dallas. "We didn't know if these recommendations actually applied to U.S. adults."

Home Monitoring of Blood Pressure - How Accurate is It?

Adults between 30 to 65 years from two U.S. Cities were enlisted in the study. Thus, these findings might not be applicable to other geographical areas and adults not in this age group, according to Vongpatanasin.

• The study team conducted large multi-ethnic studies comparing home blood pressure measurements to clinic measurements mainly in young and middle-aged adults in Dallas, Texas and Durham, North Carolina
• In 420 volunteers in North Carolina, high blood values 130/80mmHg or more measured in the clinic setting were confirmed with identical readings at home
• The team calculated the risk of stroke, heart attack and death associated with a systolic blood pressure reading made in the clinic of 130 mm Hg among 3,132 participants in the Dallas study
• During the 11-year follow up period, it was found that people with high blood pressure levels taken at home had similar heart disease risk as persons with similar levels measured by doctors in the clinic

The findings of the study suggest that home monitoring of blood pressure levels can be used to diagnose and treat hypertension.

‘Blood pressure reading taken at home is associated with similar heart disease risk as identical readings measured in the clinic by a doctor.’

"It's important to measure blood pressure at home because clinic readings might not reflect a person's true blood pressure. Some people have higher readings in the clinic because of the 'white coat' phenomenon, while studies have shown that others, especially, blacks, have lower blood pressure readings in the clinic than at home," she said.

Precautions to Follow when Measuring Blood Pressure at Home

As per the definition of high blood pressure at 130/80 mm Hg or more, nearly half (46 percent) of U.S. adults suffer from hypertension. Studies have found that an increasing number of persons including at least 30-45 percent of U.S. adults with hypertension monitor their blood pressure at home and should follow some basic precautions and the correct technique, as advised by the American Heart Association.

• Stay still and rest calmly for at least 5 minutes before measuring
• Avoid smoking or coffee for at least half hour before taking the reading
• Keep both feet flat on the floor
• Do not talk while measuring
• At least two readings should be taken one minute apart in the morning before taking your medications and again in the evening before dinner.
• Ideally, blood pressure readings should be taken every day for a week starting a few weeks following a change in medication and during the week before the doctor's appointment

Conclusion

It is important that blood pressure is accurately measured so that appropriate interventions such as medications and lifestyle alterations can be made in a timely fashion, and additionally, blood pressure values reflect the risk of heart disease and stroke. If home readings are reliable and accurate, it would make monitoring of blood pressure easier for patient and save anxious clinic visits

Reference:

1. Home monitoring confirms clinic diagnosis of high blood pressure - (https:newsroom.heart.org/news/home-monitoring-confirms-clinic-diagnosis-of-high-blood-pressure?preview=3656)

Source: Medindia

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