Dallas, TX—With a new study confirming that home blood pressure monitoring can be used to confirm clinical diagnosis of hypertension in the United States, pharmacists might be fielding a lot of questions on how best to do that.

A study in the American Heart Association’s journal Hypertension found that blood pressure readings of 130/80 millimeters of mercury (mmHg) or higher taken at home can be used to diagnose hypertension in range of U.S. adults, whether white, black, or Hispanic.

“Until now, recommendations for diagnosing high blood pressure with measurements done at home were primarily from Japanese and European studies,” explained lead author Wanpen Vongpatanasin, MD, professor of medicine and hypertension director at UT Southwestern Medical Center in Dallas. “We didn’t know if these recommendations actually applied to U.S. adults.”

According to the AHA, proper technique for measuring blood pressure includes the following:
• Being still and resting quietly for at least 5 minutes before measurements
• Avoiding caffeine or cigarettes in the half-hour before the reading
• Keeping both feet flat on the floor
• Avoid talking during the test

The recommendations also advise that two readings should be recorded 1 minute apart in the morning before taking medications and in the evening before eating. The AHA also said it is best that blood pressure readings be taken over a full 7 days, beginning a few weeks after a change in the treatment regimen and during the week before a doctor’s visit.

Researchers analyzed large multiethnic studies that compared home blood pressure to clinic measurements of primarily young and middle-aged adults aged 30 to 65 years: the Dallas Heart Study and the North Carolina Masked Hypertension study.

Among the 420 participants in the Durham, NC, clinic, high blood-pressure readings (130/80) were confirmed with similar readings at home.

In 3,132 participants in the Dallas study, meanwhile, researchers determined risks of stroke, heart attack, and death associated with a clinic systolic blood-pressure reading of 130 mmHg. During an 11-year follow up, the study team determined that patients with high blood-pressure levels measured at home had the same cardiovascular disease risk as those with similar levels measured by medical professionals.

The researchers also calculated that outcome-derived home systolic BP thresholds corresponding to stage 1 hypertension were 130mm Hg in blacks, 129 mmHg in whites, and 131mm Hg in Hispanics, respectively.

“Our data based on both regression-derived and outcome approach support home BP threshold of 130/80 mm Hg for diagnosis of hypertension in blacks, whites, and Hispanics,” study authors wrote.

“It’s important to measure blood pressure at home because clinic readings might not reflect a person’s true blood pressure,” Vongpatanasin added “Some people have higher readings in the clinic because of the ‘white coat’ phenomenon, while studies have shown that others—especially, blacks—have lower blood pressure readings in the clinic than at home.”

The article pointed out that, with the definition of high blood pressure set at 130/80 mmHg, nearly half, 46%, of U.S. adults have high blood pressure, and as many as 45% of adults measure their blood pressure at home.

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