A routine visit to the doctor's office typically results in a single blood pressure measurement. But for people on the verge of being diagnosed with high blood pressure, or hypertension, visits usually involve several additional checks at the office, along with a recommendation of having more taken at home. The study was published in the Journal of the American Heart Association.
Our paper is really to help practicing clinicians figure out what's enough when it comes to some measurements for them to feel confident that they have a good representation of patients' blood pressure outside the clinic.
Home blood pressure monitoring is a common approach after a patient has been screened at a clinic, but before the person receives an official hypertension diagnosis. That's because measurements taken in a medical office can sometimes be misleadingly high.
For some patients, nerves or stress related to being at the doctor's office can be enough to spike blood pressure. In others, conversely, their number will look normal at the clinic, but high at home because of environmental factors. The study looked at 316 adults who were not on medication for blood pressure.
Participants did not have a history of cardiovascular disease and were otherwise healthy. Using blood pressure guidelines released last November, which set new hypertension thresholds, participants who consistently took two readings in the morning and two readings in the evening would only need two days of home measurements.
If they only took one in the morning and one in the evening, the study showed three days was the ideal time frame to help confirm a diagnosis of high blood pressure. The guidelines from the American Heart Association and the American College of Cardiology, which defined hypertension as a measurement of 130/80 rather than the previous 140/90, emphasized having patients monitor their blood pressure as part of "hypertension diagnosis, treatment, and management."
They take terrible measurements of blood pressure. But whether it's in the office or at home, it can be done well. You don't need to be a rocket scientist to do good blood pressure. Patients need a period of rest before the measurement and a proper cuff size.
They shouldn't talk and should sit in a chair with an upright back with feet on the floor. Those are the key issues in avoiding predictable errors. Not everything that's available in the pharmacy has necessarily been validated, urging people already using home-based devices to bring them into their doctor's office for review at least once.