Pros/Cons of Blood Pressure Self-Monitoring

Blood pressure self-monitoring has become more common with the prevalence of mostly reliable and affordable devices for home use.

Home monitoring helps individuals diagnosed with high blood pressure, or hypertension, keep a day-to-day log of blood pressure readings, which they can take to their doctor.

But there are downsides to this practice, such as tending to rely too much on self-readings and the biggest mistake people can make — self-regulating their treatment without consulting their doctors.

“People who monitor their blood pressure at home shouldn’t go overboard,” said Harry Aldrich, M.D., head of the cardiovascular section of the Miami Cardiac & Vascular Institute at South Miami Hospital. “Most people don’t have to monitor their BP several times a day. Such frequency becomes intrusive and many people may start worrying about it.”

Ideally, physicians analyze the home-based BP readings of their patients to make sure any medication or lifestyle modifications, such as those involving diet or exercise, are working to control or reduce high blood pressure. Readings taken at home can have a significant affect on doctors’ decisions about treatments.

Taking your blood pressure reading once or twice a day is often sufficient. But self-monitoring doesn’t have to be a daily occurrence for patients with hypertension who have effectively controlled blood pressure through medication and dietary changes, Dr. Aldrich said.

It’s important for people who self-monitor to calibrate their devices at their doctor’s office, he said. And most importantly, Dr. Aldrich adds, it’s critical they don’t reduce or increase blood pressure medication based on changes in their BP readings — without consulting their physicians.

“You should never adjust your BP medication unless your doctor tells you to,” says Dr. Aldrich. “Self-regulating medication leads to sporadic BP control.”

Research has found that blood pressure self-monitoring can be helpful “in addition to regular monitoring in a healthcare provider’s office,” according to the American Heart Association. However, home monitoring is not a substitute for regular visits to your physician, the AHA emphasizes.

“If you have been prescribed medication to lower your blood pressure, don’t stop taking your medication without consulting your doctor, even if your blood pressure readings are in the normal range during home monitoring,” the AHA says.

The most recent study of BP home monitoring found that patients at high risk of cardiovascular disease saw positive results from taking their own readings. The study found that those already on medications to control blood pressure had lower readings after 12 months, compared to others with standard doctor care without self-monitoring.

“The blood pressure difference observed in those self-managing would be expected to be associated with an approximate 30% reduction in stroke risk should it be sustained,” the researchers wrote.

Blood pressure measures the force at which blood flow pushed outwards on arterial walls. Keeping your blood pressure in a normal range reduces the risk of blood vessel walls becoming overstretched and injured. It also reduces the risk of having a heart attack or stroke; and of developing heart failure, kidney failure and peripheral vascular disease.

Your doctor may choose to have you monitor your blood pressure and keep a log if:

  • You have been diagnosed with pre-hypertension, or a systolic (top number) between 120 and 139 millimeters Hg OR diastolic (bottom number) between 80 and 89 millimeters Hg).
  • You have been diagnosed with hypertension (systolic 140 mm Hg or above OR diastolic 90 mm Hg or above).
  •  You have risk factors for high blood pressure.
  • Guidelines published by the Journal of the American Medical Association recommend that people aged 60 and older should be started on medication if their blood pressure is 150/90 millimeters or higher.

    Medication is recommended for people younger than 60 when blood pressure is 140/90 millimeters or higher. The same is advised for adults of any age who have chronic kidney disease or diabetes, according to the JAMA guidelines released in February.

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