Why should I check my blood pressure at home?

Feb 24

Amended from a blog originally written by Dr Stephens for Kinetik Wellbeing.

If we’ve crossed paths before, there’s a good chance I’ve sent you home with a bit of “homework” — checking your blood pressure at home and bringing in a few readings for us to review together. I’ll happily admit that I’m a little obsessed with home blood pressure measurements. But why do I so often ask you to check it at home? Here’s why.

Improved accuracy

Many people are familiar with the term ‘white coat syndrome’, referring to the phenomenon of one’s blood pressure shooting up higher in a doctor’s office compared to sitting lower at home. This is why when doctors are first diagnosing someone with having high blood pressure (hypertension), we want to make sure that the readings we see in clinic are truly reflective of what that person’s blood pressure is like when they are elsewhere.

In fact, the National Institute of Health and Clinical Excellence (the UK body that reviews evidence to make clinical recommendations that are also referred to on this side of the pond) clearly advises that we collect home readings for most people before making a diagnosis and starting treatment (1). So, apart from the exception of those with an altered heart rhythm that can affect digital machines (such as AF, or atrial fibrillation), checking your blood pressure from home is usually more informative and likely to be more accurate than having it checked at the doctor’s office. This is especially true if you are someone who gets white coat syndrome, provided of course that your device is clinically validated (as all of Kinetik’s are) and not out of date.

Silent disease

Many times, raised blood pressure is picked up incidentally when someone goes to the nurse or doctor for an unrelated issue. This is because oftentimes people who have raised blood pressure don’t have any symptoms and so don’t necessarily make a conscious effort to have their blood pressure measured.

In fact, in England alone, there are estimated to be some 5.5 million people who have hypertension but aren’t aware of it (2). Compared to other countries such as Canada, where some 65% of adults with hypertension are both diagnosed and managed well, we are only managing some 35% in England (2). America does fare better but still not as good as our neighbors to the North, with about 55% of adults with hypertension estimated to be both diagnosed and managed well - certainly room for improvement and at least a partial explanation for my obsession!

By having healthy adults check their blood pressure at home, we can then pick up issues before they cause problems. For those who already have hypertension, being able to monitor readings at home can increase insight to how well (or unwell) their blood pressure is controlled, hopefully then leading to improved control through liaising with their family doctor and making appropriate medication and/or lifestyle changes.

Serious consequences

The reason this all matters so much is because hypertension is a massive risk factor for other, serious medical conditions. It’s actually the number one biggest risk factor for cardiovascular disease and contributes to half of all strokes and heart attacks (2). But it doesn’t stop there - raised blood pressure can also lead to heart failure, kidney disease, eye damage and dementia.

Unlike some risk factors which are impossible to alter, such as what you inherit in your genetics, high blood pressure is actually usually very treatable. For many people, this may not even involve medication. Some people whose blood pressure is only mildly elevated may be able to bring it down into a normal range by shedding a few excess pounds. (If you think this might be you, please book in with me or speak to your own Primary Care Provider.)

This is important

The combination of raised blood pressure being asymptomatic, easy to detect on testing, underdiagnosed by millions, having serious consequences, and being so treatable all at the same time mean that getting more people to test their blood pressure (even if it’s on a machine at Wal Mart if you’d rather not buy your own!), is actually a hugely important step in preventing scores of unnecessary heart attacks, strokes and deaths.

You can read more about high blood pressure here (3) or speak to your Primary Care Provider about any concerns you may have about your own blood pressure readings.