Monitoring Blood Pressure at Home

Any medical setting can make your patients nervous, particularly if they are not there for a simple check up or know they are not in perfect health. Studies now find that tests conducted in a your office might produce skewed test results because of this.

The American Heart Association (AHA), American Society of Hypertension and the Preventive Cardiovascular Nurses' Association has released a joint call to action statement addressing this issue, particularly regarding blood pressure measurements in patients with hypertension.

Studies show that 10-20% of patients with high blood pressure have a higher than usual blood pressure simply by the anxiety caused from being in a doctor’s office and the presence of a doctor, often dubbed the “white coat effect.” On the other hand, the opposite can be true as well. Patients with abnormally high spikes in blood pressure can have normal blood pressure levels at a physician’s office.

To work around this, people with hypertension are recommended to routinely check their blood pressure at home, much in the same way diabetes patients measure their blood sugar levels with glucose monitors at home. Many of these monitors can be purchased for less than $100, and the report also recommends that patients be reimbursed for its cost. What does this mean for the practicing physician?

The 11 action points advocated by the three organizations include the following:

• Home blood pressure monitoring should be routine among patients with known or suspected hypertension
• Newly diagnosed hypertension patients should be recommended to monitor blood pressure at home to differentiate between a true hypertension case and the “white coat effect”
• Home blood pressure monitoring is “recommended for evaluating the response to any type of antihypertensive treatment and may improve adherence”
• Home blood pressure monitoring is also beneficial for the elderly, diabetes patients, pregnant women, children and patients with kidney disease
• Patients should be reimbursed for the cost of purchasing home blood pressure monitors

According the 1999-2000 National Health and Nutrition Examination Survey, 65 million people in the US are affected by hypertension. In 2006 this led to a direct and indirect cost of about $63.5 billion in the US, though the report also suggests that this number is most likely an underestimate.

Instruct your patients to read more heart-friendly tips at MDNG blogger Jed Weisberger's page, "Heart Rhythms."

Would you recommend home health monitoring for your patients?