Blood pressure and self-monitoring: Is it necessary?

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Over the counter medicine, publicly available diagnostic kits, readily available (mis)information on the internet about every sort of medical ailment and how to "cure it"; never has it been so easy for the lay person to try  to take control of their own health.  Whether this helps or hinders the trained physician is not always clear, however, one readily available health device that could make a difference is the home monitor for blood pressure.  

Hypertension (high blood pressure) is the most important risk factor for cardiovascular disease, and lowering blood pressure has been istockphotoshown to  reduce this risk. Doctors use blood pressure measurements to help inform management of hypertension, and the methods used to measure blood pressure have changed very little in the last 100 years. In BMC Medicine this month, Paul Padfield discusses "The case for home monitoring in hypertension". As well as outlining some of the history surrounding blood pressure measurements, he describes the merits of the readily available self-monitoring devices, although he clearly cautions that they are not  necessarily appropriate for use in all patients. In addition, there are currently few quality control measures in place to ensure that commercial products actually function at an acceptable level. However, taking into account these caveats, Padfield calls for doctors to become more familiar with this common technology and suggests how it can improve the management of this serious condition.

Visit the BMC Medicine website and check out the full commentary to read the insights Padfield has to offer with regard to this topic.

  • wesley t. frazier md

    I am a retired Physician (Anesthesiololgist) who uses a home NIBP monitor (Omron). I also did some clinical research on various methods for measuring BP (ultrasound of various types, direct pressures at various sites–including aorta, radial artery, brachial artery, etc.). Consistent use of the home devices is probably better than many of the procedures used in most M.D. offices and will reveal how much variability there is depending on the time of day, the number of repetitions, etc. Devices are now available which will automatically take three contiguous NIBP readings and give the average. One office measurement (often through clothing) by a harried Nurse
    (with questionable hearing) may be a poor baseline for hypertension treatment. Also, few office BP devices are themselves calibrated and subject to quality control checks. More education and quality control are needed. Properly used home devices
    (excluding finger devices) can play an important role is better hypertension management.