May 22, 2008

Home Blood-Pressure Monitoring Recommended

THURSDAY, May 22 (HealthDay News) -- More than 100 million Americans should be monitoring their blood pressure at home, according to three major health organizations that are issuing recommendations on what to do and how to do it.

"We have an estimated 72 million [people] with hypertension [high blood pressure] and another 25 million with pre-hypertension," said Dr. Suzanne Oparil, professor of medicine at the University of Alabama at Birmingham.

Hypertension is a pressure reading greater than 140 over 90. Pre-hypertension is a reading higher than 120/80, the desired level, but just below 140/90.

Oparil is immediate past president of the American Society of Hypertension, one of the organizations issuing the recommendations. Home monitoring should be done, because "hypertension is the most modifiable risk factor for cardiovascular and renal [kidney] disease," she said.

Added Dr. David Goff, chair of epidemiology and prevention at Wake Forest University, and one of the American Heart Association members who helped write the recommendations: "The evidence is quite strong that home blood pressure monitoring leads to better control of blood pressure, and the evidence is quite strong that blood pressure control lowers the risk of heart attack, stroke, kidney failure and sudden death."

Nancy Houston Miller, another guidelines co-author and a past president of the Preventive Cardiovascular Nurses Association, said in a prepared statement, "Home blood pressure monitoring also gives patients the physiologic feedback they need to see regarding blood pressure."

The guidelines are published online in Hypertension: Journal of the American Heart Association, the Journal of the American Society of Hypertension, and The Journal of Clinical Hypertension, and printed in the June issue of Journal of Cardiovascular Nursing.

"Only about one third of the people with high blood pressure have it under control, so clearly new approaches are needed to get better control," Goff said. Everyday monitoring is not necessary, but blood pressure readings should be taken "several times a week," he said.

Some of the specific recommendations include:

• Patients should purchase a blood pressure monitor (some cost less than $100) with cuffs that fit on the upper arm, with advice from a health-care provider on its use. Wrist monitors are not recommended.
• Two or three readings should be taken at a time, one minute apart, while resting in a seated position. The arm should be supported, with the upper arm at heart level and feet on the floor.
• Readings should be taken at the same time every day, as recommended by a health-care provider.
• The target goal is a reading under 135/85, or less than 130/80 in high-risk individuals.

The home monitoring recommendations open the door to a totally new way of controlling blood pressure, Oparil said.

"The future will be telemedicine," she said. "You would take your own blood pressure at home and transmit it to a computer, and someone, either a physician or another caregiver, will make recommendations for adjustments in your medication."

More information

For more on hypertension, visit the American Heart Association.

SOURCES: Suzanne Oparil, M.D., professor of medicine, University of Alabama at Birmingham; David Goff, M.D., Ph.D., chair of epidemiology and prevention, Wake Forest University, Winston-Salem, N.C.; May 2008, online, Hypertension: Journal of the American Heart Association; June 2008, online, Journal of the American Society of Hypertension and the Journal of Clinical Hypertension; June 2008, Journal of Cardiovascular Nursing
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