Healthcare professionals have been recommending taking blood pressure at home for a few years, but according to a new joint statement from the American Heart Association (AHA) and the American Medical Association (AMA), it’s now “more important than ever.” The reason? Because of the COVID-19 pandemic, fewer patients are making in-office visits to their healthcare providers.
According to the new statement, “….Self-measure BP [blood pressure] monitoring is associated with a reduction in BP and improved BP control…. Therefore, self-measured BP monitoring has high potential for improving the diagnosis and management of hypertension in the United States.”
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At the same time that the AHA and the AMA issued their joint statement, the U.S. Preventive Services Task Force (USPSTF) gave a “Grade A recommendation” to professional office screening for hypertension in adults ages 18 and above while also recommending that an office finding of high blood pressure be confirmed by in-home screening before treatment is begun. According to their guidelines, “The USPSTF concludes with high certainty that the net benefit of screening for hypertension in adults is substantial.” They point out that a major reason for recommending home measuring is to counter, or correct for, what’s known as “white coat” hypertension, or as the USPSTF defines it, “blood pressure measurements that are high only when obtained in a clinical office setting but normal when obtained outside the office.”
How should you do home blood pressure monitoring? First, it’s recommended that the patient use a validated home blood pressure device that employs what’s known as the “oscillometric method.” This method analyzes pulse waves during constricted blood flow caused by a cuff that acts as a sensor. It’s the one used by nearly all “clinical-grade” blood pressure devices and the one commonly seen in the doctor’s office.
Until quite recently, doctors in the United States didn’t have ready access to information about the accuracy of blood pressure measuring devices. For that reason, in 2015 hypertension experts launched a project to establish a formal set of criteria for ranking these devices. The AMA, working with the National Opinion Research Center at the University Of Chicago, established an independent process to determine which blood pressure devices available in the United States “meet the AMA’s established criteria to validate clinical accuracy.” Their resulting “U.S. Blood Pressure Validated Device Listing,” which currently contains over a dozen devices, can be found on their website.
According to Karen S. Kmetick, PhD, AMA group vice president for Improving Health Outcomes, “With the expected increase in telehealth visits, the need for accurate self-measured blood pressure readings taken at home has never been more important. Until now, U.S. healthcare professionals have not had a convenient way to determine whether a patient’s BP device has been validated for clinical accuracy. The new U.S. Blood Pressure Validated Device Listing is an important step towards a game-changing capability. Utilizing it will help patients and physicians better partner to manage high blood pressure.”
The National Institutes of Health offers the following home measuring guidelines:
· For each blood pressure recording, two consecutive measurements are taken, at least one minute apart with the person seated.
· Blood pressure is recorded twice daily, ideally in the morning and evening.
· Blood pressure recording continues for at least four days, ideally for seven days.
The U.S. Centers for Disease Control (CDC) recommends that the home monitoring device be automated (it inflates at the push of a button; the user doesn’t need to manually inflate it with a squeeze bulb). The CDC also prefers an upper-arm cuff, as opposed to a wrist or finger cuff, and one with memory storage capacity. Finally, the agency advises that after buying a home blood pressure device, the user take it to their healthcare provider to have it checked for accuracy. The CDC also notes the increasing availability of promising devices that can be used with smartphones and tablets but says that because they are new, they have mostly not been validated by international standards.
Want to learn more about diabetes and blood pressure? Read “High Blood Pressure and Diabetes” and “Seven Little-Known Steps for Lowering Your Blood Pressure.”
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