High blood pressure is a leading cause of heart disease, and it is often called the "silent killer" because there are no symptoms.
Now, a new study shows that regular monitoring of blood pressure by patients at home can help doctors get a better handle on this dangerous condition.
Dr. Richard Stein, a cardiologist with the American Heart Association and Beth Israel Medical Center in New York City, explains to The Early Show co-anchor Rene Syler the importance of home testing and offer advice on how to incorporate it into a treatment plan.
He says, "The study actually shows that patients who took their blood pressure twice a day at home, who were known to have high blood pressure and had normal blood pressures at home did far better than patients who had normal blood pressures in the doctor's offices, but had high blood pressure at home. In fact, one in 10 people who came into a doctor's office who had a normal blood pressure in a doctor's office had high blood pressure at home and had the same heart attack rates as patients who had high blood pressure."
He notes the issue is not that the reading is inaccurate at the doctor's office, but that the patient is in a different physical and mental state. "You don't spend a lot of time sitting in offices," he says, "You spend more time walking around your home, going to work and doing things that are sort of activities of daily living. So it probably represents a better slice of life, in terms of what the blood pressure is."
High blood pressure or hypertension is when the force of blood against the walls of the arteries is too great. It adds to the workload of the heart and arteries, and over time can damage the heart, arteries and other organs. It increases the risk of stroke, heart failure, kidney failure and heart attack.
Most people with high blood pressure have no symptoms, and the only way to tell if you have it is to get it tested. It can come from any number of influences - like salt in the diet and stress - but it's not completely understood. Treatment for high blood pressure may include medications in addition to lifestyle changes, like low-fat and low-salt diets, weight loss and getting more exercise.
In a new study in the Journal of the American Medical Association, researchers concluded that home blood pressure testing gives a better overall picture of blood pressure than measurement in a doctor's office. In the study, office measurement failed to identify 13 percent of patients who had high blood pressure only in the office but not at home. It also failed to identify 9 percent of people who had a high blood pressure at home but not in the doctor's office.
Generally speaking, blood pressure is usually lower in the morning and higher in the evening. But because blood pressure can fluctuate throughout the day, a doctor may recommend that a patient test his own blood pressure at home to keep better track of it.
Dr. Stein advises his patients to write down the information "on a card with the time and your pulse and blood pressure. When I see you in the office I have the opportunity to look at not only the blood pressure at the time I saw you but what you were doing in the home."
Home testing gives a doctor access to more information that can help him to better treat the patient. It can reveal the severity of the problem. If the blood pressure is higher at certain times of the day, it can help the doctor with timing medications.
More self-awareness on the part of the patient can lead to better understanding of hypertension and increase the likelihood that lifestyle changes will be made and/ or medications will be taken as directed. Because there are no symptoms, some patients don't believe they have a problem until they see the results for themselves on a regular basis. Home testing can also help the patient better understand that hypertension is not causing symptoms like headaches.
There is a wide variety of consumer blood pressure testing kits available from a pharmacist, and the prices vary greatly. There are very simple ones similar to the kind doctors use, and more sophisticated automated digital ones that are more expensive.
Accuracy can vary, too. The basic advice from the American Heart Association is to consult with your doctor before you buy one, and use it in conjunction with your doctor as part of your ongoing care.
Report the results to your doctor on a regular basis to make sure you're getting the appropriate treatment. It's important to remember that the test is not an alternative to a visit to the doctor.
Bring the test equipment to your doctor first to make sure you're using it properly, and compare your measurement with your doctor's measurement. Make sure you can return or exchange the test kit for a different one if your doctor is not satisfied with the results, or if you have trouble using it.
Last year, the National Heart Lung and Blood Institute issued stricter definitions for high blood pressure, saying doctors should be much more aggressive with people showing early signs. A reading of 120 over 80 is now the upper limit of healthy blood pressure, and people with diabetes should keep blood pressure even lower.
The guidelines urge early intervention with lifestyle changes for "pre-hypertension" or blood pressures between 120 over 80 and 139 over 89. Medications should be considered for people with pressures above 140 over 90.