A Joint Scientific Statement from the American Heart Association, American Society for Hypertension, and Preventive Cardiovascular Nurses Association

Date: May 22, 2008

Summary: Home blood pressure monitors that use an electronic sensor to detect blood flow are effective at measuring blood pressure accurately and are more accurate than measurements taken in the doctor’s office. They should be used by patients in their homes. Insurance plans should cover the cost.

Journal: Hypertension

Journal citation: Hypertension. 2008;52:1-9

Read the complete article: http://hyper.ahajournals.org/cgi/reprint/52/1/1

Why it’s important: Most high blood pressure is detected and monitored by measurements taken in the doctor’s office. These can be misleading. Often, such readings are higher than “actual” pressure, which is really blood pressures averaged over time. Home blood pressure monitoring provides better quality measurement of a patient’s average blood pressure. Many new home blood pressure monitors are accurate, inexpensive and easy to use. Doctors should recommend that their patients use these devices to help monitor and control blood pressure.

What’s already known: National and international guidelines already recommend home blood pressure monitoring. Studies show that home blood pressure monitoring can be used to diagnose high blood pressure. It is also valuable in getting patients involved with their treatment. This makes it more likely that they will take prescribed medicine and change their eating and exercise habits. Home blood pressure monitoring can also help in treating diabetes and maintaining the health of older people. It can even enable physicians to monitor problems in pregnancy.

How this study was done: This paper reviews previous studies and trials of home blood pressure monitoring. From this review, a group of experts recommended standard guidelines for the use of home blood pressure monitoring.

What was found: The evidence supports routine use of home blood pressure monitoring in diagnosing and following patients with high blood pressure as well as those with other health problems involving high blood pressure. Patients should purchase home blood pressure devices that use a cuff on the arm and not those that clasp the wrist. The monitors should use an electronic sensor to measure blood flow and determine blood pressure. Physicians or their staff should train patients to use the monitors accurately. Patients should take two or three readings (while resting in an upright seated position with legs uncrossed) in the morning and again at night, for at least one week. The authors recommend at least 12 readings before doctors decide whether a patient has high blood pressure. Later, home blood pressure monitoring could help patients stick with treatment that may involve medicine, diet and exercise.

“I hope this leads to a new era in patient-doctor partnerships,” said Thomas Pickering, M.D., D.Phil., the leader of the team that wrote the guidelines. “I think this is a very healthy trend, and with a condition like high blood pressure, it really does depend on the patients’ remembering to change their lifestyles or remembering to take their pills.”

Because home blood pressure monitoring can reduce the cost of care and improve the health of patients, the experts recommend that the cost of the machines be covered by insurance and/or government programs. “Cost should not be a barrier to patients receiving the documented benefits of home blood pressure monitoring,” the authors wrote.

The bottom line: Getting a device to monitor your blood pressure at home can help you more effectively manage high blood pressure than simply relying on your doctor’s readings.



This content is reviewed regularly. Last updated 7/28/08.