In a study from Yale, scientists found blood pressure measurements taken in a medical office can vary widely between visits.
These large variations in blood pressure measurements pose a great challenge to determine whether hypertension treatment is actually working.
The findings offer further support for guidelines that call for blood pressure home monitoring.
Nearly half of U.S. adults have high blood pressure, also called hypertension, and just 1 in 4 have the condition under control.
High blood pressure is defined as having a systolic blood pressure – the top number – of 130 mmHg or higher or a diastolic reading – the bottom number – of 80 mmHg or more.
Research shows uncontrolled hypertension can lead to heart attacks, strokes, heart failure, kidney disease, vision loss and other health conditions.
High blood pressure in midlife and beyond also has been linked to cognitive decline and dementia.
In the study, the team analyzed more than 7.7 million blood pressure measurements for 537,218 adults, who were an average 53 years old and treated in the Yale New Haven Health System.
Overall, the team found wide variations in blood pressure measurements between two consecutive visits, averaging about 12 mmHg.
In people with blood pressure in the normal range, systolic levels varied an average 6.3 mmHg between two consecutive visits.
But among those with extremely high blood pressure – above 180 mmHg systolic – levels varied considerably more, an average 32.3 mmHg.
The team found that if a person with high blood pressure was given medication to lower systolic levels by 10 mmHg, they would see a reduction of 5 mmHg or less at the next visit 37% of the time and no reduction 25% of the time.
It would therefore take about four follow-up visits to be 80% certain a patient’s systolic blood pressure had been lowered.
The team suggests that to accurately take a measurement, don’t exercise, smoke or consume caffeine within 30 minutes before measuring your blood pressure. Empty your bladder and quietly sit still for at least five minutes.
The arm is used for measurement should be on a flat surface, such as a table, with the upper arm at heart level.
The bottom of the cuff should be directly above the bend in the elbow against bare skin. Sit with your back straight and supported, with your feet flat on the floor.
Take at least two measurements one minute apart in the morning before taking medications or eating breakfast and again in the evening before supper.
If you care about blood pressure, please read studies about probiotics could help reduce high blood pressure, blood sugar and cholesterol. and findings of Certain plant-based foods could benefit people with high blood pressure.
For more information about blood pressure, please see recent studies about added sugar in your diet linked to higher blood pressure, and results showing plant-based foods could benefit people with high blood pressure.
The study was conducted by Yuan Lu et al and published in Circulation: Cardiovascular Quality and Outcomes.
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