03 May 2010

BP: home check better

The best way to predict your risk of stroke or heart attack due to high blood pressure is through systematic monitoring at home rather than periodic checks in the doctor's office.


Think you need to go to the doctor's office to check your blood pressure? Think again: The best way to predict your risk of stroke or heart attack due to high blood pressure is through systematic monitoring at home rather than periodic checks in the doctor's office, new research suggests.

"With home blood pressure monitoring you get a greater number of measurements and there is no white-coat effect," lead author Dr Teemu Niiranen told Reuters Health, speaking of the tendency for anxiety to drive up blood pressure. "At home the patient is more relaxed and this seems to provide blood pressure values that reflect the patient's true blood pressure better."

Writing in the American Heart Association's journal Hypertension, Niiranen and colleagues at Finland's National Institute of Health and Welfare concluded that home-measured blood pressure is a better predictor of heart disease-related problems than office-measured blood pressure.

High blood pressure is a major risk factor for heart disease, stroke, and kidney disease, and nearly one in three Americans have high blood pressure, according to the Centres for Disease Control. In 2006 it contributed to the deaths of 326 000 Americans.

How the study was done

The researchers used data on more than 2,000 Finns, 45 to 74 years old, gathered between 2000 and 2001. Participants agreed to be interviewed, undergo medical exams and monitor their blood pressure at home on well-calibrated monitoring devices.

At follow-up nearly 7 years later, 162 participants reported at least 1 non-fatal heart disease-related event such as a heart attack, stroke, or hospitalisation due to heart failure. Among the 2,081 participants, 37 heart disease-related deaths were reported.

After analysing the data, the Niiranen group concluded that the best predictor of heart attacks, strokes, and related deaths was home blood pressure monitoring.

The home blood pressure readings, because there were more of them and they weren't affected by the "white coat effect," were more accurate, the authors found.

The home blood pressure monitor used in the study - Omron's HEM-722c, comparable to the HEM-712c in the U.S. -- costs about $70. Niiranen said 60% of Finnish patients with high blood pressure have home monitors.

While the study was done in Finland, Niiranen said there's no reason to believe these results would not also apply to the populations in other countries.

The study could not determine whether home monitoring could save lives, however, since it was only observational, Niiranen said. - (Reuters Health, April 2010)


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Dr Jacomien de Villiers qualified as a specialist physician at the University of Pretoria in 1995. She worked at various clinics at the Department of Internal Medicine, Steve Biko Hospital, these include General Internal Medicine, Hypertension, Diabetes and Cardiology. She has run a private practice since 2001, as well as a consultant post at the Endocrine Clinic of Steve Biko Hospital.

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