For some people, just the thought of walking into a doctor's office can immediately make their blood pressure levels shoot up. Some people may even experience dangerous spikes in their blood pressure levels upon waking up or several times during the day.

These are just some of the reasons why the United States Preventive Services Task Force (USPSTF) recommends monitoring blood pressure levels at home.

Stress, caffeine intake, nicotine and physical activities can make blood pressure levels rise. Many patients experience what has been dubbed as "white coat hypertension," a rise in blood pressure levels caused by stress at a doctor's office during blood pressure tests. These external factors make it difficult for doctors to determine if a patient really has high blood pressure.

Dr. Kirsten Bibbins-Domingo, USPSTF vice-chair expressed that high blood pressure should be confirmed outside the doctor's office before hypertension treatment starts. Bibbins-Domingo added that the USPSTF recommendation isn't applicable to patients with kidney and heart damage and very high blood pressure. The USPSTF recommendation is best suited for individuals who want to confirm if they really have hypertension.

"We're encouraging physicians to confirm a new diagnosis of high blood pressure in their patients using either ambulatory blood pressure monitoring, which means wearing a cuff for 24 hours while the blood pressure gets checked every 20 or 30 minutes, and confirming that the blood pressure isn't just elevated in the office, but that it's also elevated at home or at work," said University of Georgia's Dr. Mark Ebell, who is also a member of the task force.

Using ambulatory blood pressure monitoring (ABPM) and home blood pressure monitoring (HBPM), doctors can better determine who can be given lower doses of medication. With patients monitoring their blood pressure levels in the comforts of their own home, doctors can also better determine whose blood pressure shoots up during a regular checkup but remains perfectly normal at home.

The habit will also flag those whose blood pressure spikes in intervals during daily activities but returns to normal at the site of a doctor's office.

A portable blood pressure measuring device can be provided by physicians. This device can measure blood pressure from 12 to 48 hours every 20 to 30 minutes. Individuals can also make use of home blood pressure monitoring devices.

The USPSTF recommendations were circulated online in the Annals of Internal Medicine journal on Oct. 13.

Photo: Philip Wong | Flickr 

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