New research suggests that too many people may be unnecessarily undergoing treatment for high blood pressure.
It’s estimated that around a third of all adults suffer from hypertension, a disease that increases the risk of developing serious health conditions including heart attacks and strokes. However this new research indicates that we may be tracking this dangerous condition using readings from a device that’s out of date.
The sphygmomanometer, first developed in the late nineteenth century, is still used to measure blood pressure today. And, while it still works well when reading blood pressure in the doctor’s office, it’s believed that using newer, more portable devices more regularly throughout the day can give a better picture overall. Ambulatory blood pressure monitors use a cuff fitted with a microchip in order that they can measure blood pressure at regular intervals, automatically. They can show what is triggering high blood pressure, inflating when smoking for instance, as well as reflecting the effect of beneficial activities such as yoga, deep breathing or meditation.
Ambulatory blood pressure monitors also take blood pressure readings when users are asleep, a part of the day is which still largely baffles scientists. However it is known that around an hour into sleep blood pressure in healthy people drops by 10 to 20 percent, staying low until shortly before waking. In people termed ‘non-dippers’ blood pressure doesn’t fall in this way. And more and more evidence is leading us to believe that nocturnal blood pressure readings are a more reliable way of predicting risk of heart attacks than day time readings.
Home blood pressure monitors useful but not perfect
Home blood pressure monitors have been with us for some time. But they can be susceptible to human error, and since the user decides when to take readings this may not give a wholly accurate picture of blood pressure. People often wrongly write down readings, leaving out the high readings or rounding them down a bit. Recent advances in hypertension technology have made these mobile devices more reliable, and they have allowed us to see what the doctor’s surgery readings have missed.
Why ambulatory blood pressure monitors should be more widely used
While the use of more ambulatory blood pressure monitors is recommended, the cost of machines, software and trained physicians is high. That’s why despite all the advantages use remains low – ambulatory blood pressure monitoring (ABPM) is restricted to hypertension specialists, of which there are around 1500 in the US. However results from a Minneapolis clinic that decided to start their own ABPM program might change minds. They revealed that round 45 percent of people previously diagnosed with high BP had in fact normal blood pressure – and that’s in people who in surgery had recorded readings as high as 160.
In the UK ambulatory testing has become the recommended path for anyone suspected of having hypertension. A report in the Lancet confirmed that this is expected to save the NHS $15 million over the next five years, mainly by avoiding the cost of treating people with ‘white coat’ hypertension. And with the American Heart Association putting the cost of hypertension in the US at $156 million annually, these types of savings here would be hugely appreciated.
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