REPORT: Best way to track blood pressure

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A new study revealed that blood pressure readings taken with a portable monitor may be a much better indicator of a patient’s prognosis than those taken at the doctor’s office.

Researchers studied nearly 64,000 adults and discovered that “ambulatory” blood pressure monitoring was significantly more effective at predicting a patient’s risk of dying over the next five years, versus doctor’s office readings, Web MD reported.

“The difference is striking,” said lead researcher Dr. Jose Banegas, of the Autonomous University of Madrid, Spain, who also noted that the findings offer “unequivocal evidence” to support ambulatory monitoring.

“There is no scientific or clinical justification for not using ambulatory blood pressure monitoring, which should be part of the evaluation and follow-up of most hypertensive patients,” Banegas said, using the medical term for high blood pressure.

In order to record ambulatory blood pressure, patients wear a small monitor for 24 hours during which their blood pressure is automatically recorded approximately every half hour. According to Dr. Raymond Townsend, of the University of Pennsylvania, ambulatory monitoring captures real-time changes in blood pressure.

Ambulatory monitors can detect “masked” high blood pressure, Townsend said, which are cases in which people have normal readings at the doctor’s office, but experience hypertension in daily life.

Townsend, who wrote an editorial published with the study in the April 19 New England Journal of Medicine, noted that ambulatory monitors have existed for a long time, but they are used “infrequently” in the United States because insurers often will not cover the cost.

Eileen Handberg, a member of the American College of Cardiology’s Prevention of Cardiovascular Disease Leadership Council, is hopeful that the new findings will encourage wider use of ambulatory blood pressure monitors.

Handberg, who was not involved with the research, said it is “hard to argue with” the outcomes from such a large study, which was based on a Spanish registry with information on almost 64,000 adults whose primary care doctors ordered ambulatory blood pressure readings for various reasons.

If a patient is questioning whether they truly have high blood pressure, or whether their blood pressure medication is working, Handberg said that ambulatory monitoring might be wise.

If an ambulatory monitor is not available, a home monitor is the next best thing, according to Banegas.

Townsend concurred, noting that a home monitor will not allow continuous readings, but using one regularly will give a person “additional information.”

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