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By Jill Ross, HealthAtoZ contributing writer
If getting your blood pressure checked at the doctor's office makes you sweat, then you may be relieved to learn that a study has found that home blood pressure tests may be more accurate than those taken at the doctor's office.
In a study of elderly men and women with high blood pressure, French researchers discovered that home blood pressure measurements more accurately identified patients at risk for future heart attack and stroke than those tests performed at the doctor's office.
The researchers concluded that people who are being treated for high blood pressure should self-monitor at home in addition to getting their blood pressure checked at the doctor's office. At-home monitoring is a method most patients prefer, according to the researchers.
At-home tests reveal hidden risks
The study, which was reported in The Journal of the American Medical Association, involved nearly 5,000 elderly patients being treated for high blood pressure.
At the end of the three-year study, 324 patients had suffered a cardiovascular event, such as a heart attack or stroke or needing heart surgery.
Researchers also found that each 10-point increase in a patient's at-home systolic blood pressure (the top number of a blood pressure reading) increased the risk of a heart attack or stroke by 17 percent. Each 5-point increase in a patient's at-home diastolic blood pressure (the bottom number) increased the risk by nearly 12 percent.
Blood pressure daily rhythm
The doctor's office measurement of your blood pressure is a snapshot, yet blood pressure fluctuates during a 24-hour period. Blood pressure peaks during daytime hours, and can vary with work, activity, and possibly by race and age. It can also surge during stressful events. For some people, this includes when a doctor or nurse approaches them with the blood pressure cuff. The phenomenon has its own name - "white-coat hypertension."
To detect these artificially high readings, blood pressure is measured in the doctor's office several times, and also away from the office. If a person's blood pressure is consistently lower when measured at home, that may indicate white-coat hypertension.
A blood pressure level of 140/90 or higher is considered high. About two-thirds of people over age 65 have high blood pressure, according to the National Heart, Lung, and Blood Institute (NHLBI). Blood pressure between 120/80 and 139/89 - which used to be considered within the normal range - is now considered "prehypertension" under NHLBI guidelines.
Shopping for a monitor
If you are in the market for a home blood pressure monitor, ask your doctor about what type would be best. According to the American Academy of Family Physicians (AAFP), tests have shown that finger or wrist devices are extremely sensitive to position and body temperature and do not measure blood pressure very accurately. They are also more expensive (more than $100) than other monitors.
The AAFP has this advice about features to look for in a home blood pressure monitor:
- The right cuff size is very important. Ask your doctor, nurse or pharmacist to tell you the cuff size you need for your arm. Blood pressure readings will be wrong if your cuff is the wrong size.
- Make sure the numbers on the monitor are easy for you to read.
- If you are using a stethoscope, you must be able to hear heart sounds through it.
- Cost may be an important factor. Since home blood pressure units vary in price, you may have to shop around. The most expensive units might not be the best or the most accurate.
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External Sources
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Bobrie G. et al. Cardiovascular prognosis of "masked hypertension" detected by blood pressure self-measurement in elderly treated hypertensive patients. JAMA 2004;291:1342-1349.
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American Academy of Family Physicians
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National Heart, Lung, and Blood Institute
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This article was reviewed and updated June 2007.
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