(DURHAM, NC) Blood pressure measured at home is a better predictor of heart disease risk than blood pressure (BP) measured during doctor visits. However, finding time to review a long list of home blood pressure readings during primary care appointments can be a challenge.
A new study from Duke University School of Medicine and the University of North Carolina at Chapel Hill examines a potential solution: a simplified method called “home BP load.”
The method concentrates on the proportion of measurements that surpass a specific threshold, such as 130 mmHg, rather than averaging several values. For instance, if half of a patient’s measures at home are higher than that, their average blood pressure probably is as well, suggesting a higher risk of heart attack and stroke.
The method could assist hectic clinics in promptly determining the treatment requirements for the millions of adults in the United States who suffer from hypertension, or high blood pressure.
For 10 days, 420 adults of various races took blood pressure readings at home twice a day as part of the study, which was published in the Journal of Hypertension. Even with only three days of data, researchers discovered that a patient’s total blood pressure could be predicted with 90% accuracy using their home blood pressure load.
Anthony J. Viera, MD, professor and chair of the Duke Department of Family Medicine and Community Health, and Alan L. Hinderliter, MD, a cardiologist at UNC Health, led the study.
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“Office blood pressure readings (are) just a one-point-in-time measurement that may not represent a person’s true average BP,” Viera said. “Repeated BP measurements outside the office give us a more comprehensive picture of a patient’s blood pressure status.”
If blood pressure remains up at 130 mmHg or above, it can harm the heart and arteries. Usually, there are no symptoms or indicators of high blood pressure. Checking a person’s blood pressure is frequently the only way to determine whether they have high blood pressure.
To diagnose hypertension and determine if blood pressure control medications are effective, medical professionals use home blood pressure readings. The study suggests that home BP load could assist physicians in making more accurate treatment decisions and eventually improve patient outcomes by streamlining the process of assessing home blood pressure measurements.
“Most of the time, clinicians are tasked with trying to average a list of blood pressure measurements brought in by patients,” Viera said. “These lists can sometimes be quite lengthy, which makes it time-consuming during a busy and brief office visit. This approach—counting the number of readings above the threshold—is much simpler.”
The study’s inclusion of Black patients, who made up 90 of the participants, was one of its main strengths. The prevalence of high blood pressure among Black Americans is among the highest worldwide. The majority of study participants had at least one high blood pressure reading at a primary care visit and were under 60 years of age.
The results, however, might not be entirely generalizable to patients with numerous medical disorders, older persons, or those with less regular monitoring practices.
The National Heart, Lung, and Blood Institute (award R01 HL098604) provided funding for the study, and the National Institutes of Health (grant UL1 RR025747) contributed additional funding.