By Christine Haran
For most people, having their blood pressure taken means pushing up their sleeve and handing one of their arms over to a nurse or doctor. But a new study shows that people who take their own blood pressure at home wind up needing less high blood pressure medication.
In the study, published in the February 25th issue of the Journal of the American Medical Association, 400 patients were divided into two groups and followed for one year. One group was assigned to have their blood pressure taken regularly at the physician's office and the second group took their blood pressure at home.
Although the at-home method didn't offer improved blood pressure control in the long run, the researchers found that the group that took their blood pressure at home needed less medication and was twice as likely to be able to go off their blood pressure drugs altogether. Not surprisingly, the at-home approach was also marginally cheaper than taking blood pressure at the office. And there was no difference between the two groups in terms of overall well-being or the size of the left ventricle of the heart, which can increase when someone has high blood pressure and lead to heart failure.
The researchers attribute the lower at-home blood pressure levels to an absence of what is known as the "white-coat effect." "Often in the clinic environment, the patient's blood pressure is elevated by the white-coat effect," says Jan A. Staessen, MD, PhD, a professor in the department of molecular and cardiovascular medicine at the University of Leuven in Belgium. "The white-coat effect occurs when the patient experiences anxiety in the doctor's office, which increases the heart rate and blood pressure."
According to Dr. Staessen, about 30 percent of patients with high blood pressure in the physician's office actually have lower measurements when they take their blood pressure at home. This artificially elevated blood pressure level can lead to the overdiagnosis or misdiagnosis of blood pressure, Dr. Staessen says.
Dr. Staessen adds that more studies are needed to establish the normal range of home blood pressure before treatment can be based on at-home measurements exclusively. For now, he says, "If blood pressure is elevated in the doctor's office, it would be wise to have it confirmed at home."
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