Random blood pressure measurement does not reflect enough the degree of blood pressure and the risk involved.
Hypertension is a major risk factor for arterial diseases of different types (coronary artery disease, the arteries of the brain, and peripheral arteries).
Naturally, blood pressure is inherently prone to changes as a result of different stimuli and therefore random measurement does not reflect enough the level of blood pressure and the risk involved. In recent years, the means to measure blood pressure outside of the clinic have evolved and that now allow a better assessment of blood pressure:
- 24 hours blood pressure monitoring
- self-measurement of blood pressure
Of the two modes of measurement outside the clinic, the measurement capability is superior in clinic to assess the risk of complications such as: thickening of the heart muscle, myocardial infarction, stroke, urinary protein excretion, kidney function decline and so on.
Self-measurement of blood pressure monitoring has several advantages over 24 hours:
- Ease of repeated testing
- Ability to perform on own thereby empowering patients
- According to some studies, the sense of control over the situation brings about a better response to treatment
Do not encourage the use of self-measurement in subjects where the measurements cause the subjects anxiety, and in those where it encourages them to initiate their own changes to the medication. It is better to use digital devices for measuring the arm (better than the forearm) as approved by authorized parties.
in others, a series of measurements should be encouraged : for example four measurements in the morning (before taking morning medication) and four measurements in the evening for 4 days duration. All the measurements should be recorded and shown to the doctor. An average of 32 measurements is calculated, and if blood pressure is less than 135/85 mm Hg blood pressure can be seen as balanced (except for in diabetics who need even lower values.) Such a series of measurements must be performed at a frequency that is dependent on the balance of the blood pressure levels. There are people whose blood pressure does not reach equilibrium once in 3 weeks and those whose blood pressure is well balanced once in three months.
Blood pressure should not generally be measured daily and there is no measurement taken (or conclusions drawn from the results of measurement) when feeling unwell (such as a headache) because the bad feeling will bring about increased blood pressure that does not reflect the reality at another time.
Tip delivered courtesy of Dr. Michael Burstein
Department of Internal Medicine, Center for blood pressure treatment, Hadassah Mount Scopus.