In a healthy person, blood pressure rises and falls throughout the day. But pressure higher than normal for a long time can damage health and cause health problems. In India, hypertension is poorly controlled and many hypertensive patients are living with a disability or affected with cardiovascular disease.
Current data suggest that efforts are needed to support self-monitoring in hypertensive patients because it plays important role in the management of hypertension along with medical therapy.
Why self-monitoring at home is needed?
Hypertension for a longer period can damage the heart, kidney, and brain. Patients with high blood pressure are at higher risk of complications like heart attack, heart failure, stroke, kidney failure, and many others. Hence to avoid these complications regular BP monitoring is very important. Some of the hypertensive patients check their blood pressure by visiting doctors. But, it is not always possible for patients to visit doctors and check-up their blood pressure. Hence, most often we advise patients to self-monitoring of their BP levels.
How self-monitoring can be done at home?
Firstly, understand the correct way to take a blood pressure reading. It can be done by using home blood pressure monitoring (HBPM) devices, typically known as sphygmomanometers. It records blood pressure across different points in a time outside of a clinical or community setting, mainly at home.
A blood pressure reading involves two numbers as 120/80 mmHg for a normal healthy person:
(1) The top number 120 indicates systolic blood pressure; it is the pressure in the blood vessels when the heart beats.
(2) The bottom number 80 represents diastolic pressure; it is the pressure in the blood vessels when the heart rests between the beats.
The blood pressure level for a hypertensive person is 140/90 mmHg. If a person has greater BP than this, then he/she might be at risk of developing heart diseases. Blood pressure varies during the day: it is highest after waking for short time and lowest at night. Therefore, when comparing results, it is important to compare readings that were taken at the same time of day.
Benefits of self-monitoring
Self-monitoring helps a person to measure BP at different times throughout the day and over a longer period. It also assists a doctor to get a more complete picture of a person’s blood pressure readings at different times. It can better predict cardiovascular morbidity and mortality rather than single, routine blood pressure measures that occur during a clinical visit. Let me brief some more benefits of home blood pressure monitoring.
Avoiding false diagnosis
Ø Research involving 24-hour ambulatory blood pressure monitoring indicates that most people experience two peaks in their blood pressure each day, typically between 6 and 8 AM and later between 5 and 8 PM.
Ø Blood pressure is typically elevated by 30 to 50 mmHg during these peak periods.
Ø Some patients with early hypertension may only experience higher blood pressure during one of the peak periods.
Ø Because these peak periods fall outside of normal schedules of doctor’s appointment times, could go without a diagnosis.
Ø Thus, self-testing provides the opportunity to measure BP during these peak periods and helps the doctor identify early-onset hypertension.
Identifying white coat hypertension
Ø Some of the individuals experience higher BP, when in a medical setting due to the stress of being in the doctor’s clinic or hospital.
Ø Self-testing is an effective way to rule out such type of situational high blood pressure known as “white coat hypertension”.
Ø At-home testing helps to identify the situational elevation in BP, and also helps to track daily blood pressure readings.
Monitoring treatment outcomes
Many individuals experience various symptoms when dealing with hypertension. Regular monitoring at home practically helps to create a baseline for such symptoms and provides valuable information regarding treatment outcomes which help doctors in drug and dosage adjustment.
Observing complications and emergency treatment
Home-based monitoring can also help in detecting complications and delivering needed emergency treatment. Individuals with hypertension may suffer from different complications, including diabetes, heart disease, hyperlipidemia, kidney disease, hyperthyroidism, etc. If the hypertensive patient is present with such other complications, then strict BP control is required. For example, If a person has general hypertension, then needs to regulate blood pressure at 140/90mmHg; however, if the hypertensive person also has diabetes or kidney disease, then needs to control at 130/80mmHg levels.