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09 February 2010

Self-monitoring at home

There seems to be a definite trend toward self monitoring, as people are encouraged to actively participate in the management of their health.

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There seems to be a definite trend toward self monitoring, as people are encouraged to actively participate in the management of their health.

Home blood pressure measurements are recommended by many experts. It offers the following advantages:

  • To distinguish true hypertension from “white coat hypertension”. This is where blood pressure is consistently elevated at your doctor or clinic but normal at other times.
  • To assess your response to hypertension medication. This can help your doctor evaluate the effectiveness of drugs and to make appropriate adjustments.
  • Taking and recording blood pressure at home may motivate you to take treatment correctly and stick to the lifestyle changes.
  • It can potentially reduce costs.

Any disadvantages?
Blood pressure varies during the day and some people become anxious about it. Understanding hypertension and talking to your caregiver will help. Home testing is difficult for people with visual of hearing impairments, including the very elderly.

Use the right tools
Done correctly and consistently, self measurement can be a very useful guide for your health professional. However, it is very important to use only validated measurement tools. Finger monitors are regarded as inaccurate. High quality electronic devices are user-friendly and accurate. Any home device should periodically be compared with a mercury sphygmomanometer to validate the readings.

Before you take your blood pressure
Relax and sit down for five minutes, do not take any coffee or cola for about 30 to 60 minutes before the test. Don’t test yourself if you have just had vigorous exercise. Smokers should not smoke for an hour before the test. If you do smoke, make every effort to stop, as smoking is a major risk factor for heart disease and stroke.

When to take your blood pressure
Readings are usually higher in the morning than late afternoon or evening. It is good to establish a routine. Periodic readings at different times of the day is useful though, as it may indicate the need for some medication to be given more than once daily.

Write it down
Record your readings (date and time of measurement) and discuss it with your health professional. It is also useful to include at what time you took your medication.

When is a home reading seen as high?
Home measurements tend to give lower readings. The data used by your health professional is based on those taken in clinical settings. Therefore a blood pressure of 135/85 mm Hg can be regarded as elevated. Discuss this with your doctor.

(Dr Kathleen Coetzee, MBChB)

Read more:
What do the numbers mean?
Hypertension and essential fatty acids

 
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