Is blood pressure reading more accurate at home or clinic?

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In a new study from Kaiser Permanente, researchers found blood pressure measurements routinely taken at home are more likely to provide the basis for accurate diagnoses of hypertension than those taken in a clinic setting.

They tested 510 adults who visited one of 12 Kaiser Permanente primary care centers in Western Washington between 2017 and 2019.

They used electronic health records to identify potential participants who were at high risk of having hypertension based on a recent clinic visit.

They then randomly divided the participants into 3 groups based on the method for obtaining follow-up blood pressure measurements: in the clinic, at home, or at kiosks in medical clinics or pharmacies.

In addition to these measures, every participant received 24-hour ambulatory blood pressure monitoring, or ABPM, the gold standard test for making a new diagnosis of hypertension.

The team found blood pressure readings taken at home were consistent with ABPM.

Blood pressure readings based on follow-up clinic visits were much lower for the systolic measure, leading to over half of the people with hypertension based on ABPM being missed.

Blood pressure readings from kiosks were much higher than measures based on ABPM, resulting in a higher likelihood of overdiagnosis of hypertension.

The findings showed that home blood pressure monitoring was a better option because it was more accurate than clinic blood pressure readings.

The number of people in the United States with undiagnosed hypertension is likely to be in the millions.

One recent analysis estimated that 23% of U.S. adults with high blood pressure were unaware that they had the condition and were not receiving treatment.

Proper diagnosis of hypertension can save a patient’s life. When hypertension is identified, physicians will typically prescribe medication to lower blood pressure.

Without treatment, hypertension can cause heart attack, stroke, and kidney damage, among other problems.

Current guidelines for diagnosing hypertension recommend that patients who have high blood pressure readings in the clinic have another test to confirm the results.

While the guidelines recommend ABPM or home blood pressure monitoring before making a hypertension diagnosis, research shows that providers continue to use in-clinic measurement when conducting the second reading.

If you care about blood pressure, please read studies about sleepless nights linked to high blood pressure and findings of calcium and magnesium in drinking water may lower blood pressure.

For more information about high blood pressure, please see recent studies about blood pressure recording over 24 hours could predict heart disease best and results showing that over half of patients skip or stop using high blood pressure drugs.

The study is published in the Journal of General Internal Medicine and was conducted by Beverly B. Green et al.

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