Should older adults regularly check their blood pressure at home?

• Hypertension, or high blood pressure, is a health condition that affects millions of people.
• While hypertension can be deadly when one’s blood pressure gets too high, it is easy to monitor using a blood pressure cuff.
• Researchers surveyed adults between ages 50 and 80 and asked them questions about various health issues, including hypertension.
• The researchers who reviewed the poll were concerned after learning that less than half of people who should be self-monitoring their hypertension are actually doing so.

In a new review letter published in JAMA Network Open, a group at Michigan University’s medical learning center highlighted concerns about the number of people self-monitoring their blood pressure.

Using data collected from the university’s National Poll on Healthy Aging, the researchers learned that in addition to less than half of these older adults checking their blood pressure regularly, many of them were not instructed to do so by medical providers, either.

What is hypertension?

Hypertension is another way of saying someone has high blood pressure, and hypertension can happen for a number of reasons.

When someone eats a diet that is high in salt or cholesterol, this can contribute to high blood pressure. Also, according to the Centers for Disease Control and Prevention (CDC), people with health conditions such as diabetes and obesity may have elevated blood pressure.

Medical providers measure blood pressure with a blood pressure monitor or cuff. People can use these at home to measure their blood pressure as well.

The American Heart Association describes the following blood pressure readings:

• A healthy range of blood pressure is a systolic (upper number) reading of less than 120 mmHg and a diastolic reading (lower number) of less than 80 mmHg.
• Elevated blood pressure is a reading of 120-129 mmHg and less than 80 mmHg.
• Hypertension Stage 1 occurs when someone’s blood pressure reading is 130-139 mmHg and 80-89 mmHg.
• Hypertension Stage 2 occurs when someone’s blood pressure reaches 140 mmHg or higher and 90 mmHg or higher.

According to the CDC, nearly half of the adults in the U.S. have high blood pressure. While many people may think hypertension is a problem only older adults face, recent studies show that it affects younger adults, too – one in eight adults from ages 20 to 40 has hypertension.

The CDC reports that only 24% of adults have their hypertension under control, and if they do not manage hypertension, it can lead to heart attack and/or stroke.

Fortunately, there are a number of ways to manage hypertension, including making dietary changes, adding exercise, and taking blood pressure medication.

Less than half of people regularly check

The researchers reviewed Michigan University’s National Poll on Healthy Aging, which was conducted in January last year.

The researchers randomly selected people between the ages of 50 to 80 and evaluated their responses. This is the age group most impacted by hypertension.

Some information the participants provided includes their height, weight, and health issues.

According to the authors, the health issues the researchers looked for included: “stroke, coronary heart disease, myocardial infarction, congestive heart failure, diabetes, and chronic kidney disease.”

Additionally, the participants indicated whether they self-monitored their blood pressure and answered whether their healthcare professional had instructed them to do so.

Approximately 48% of the respondents who either have hypertension or have a health condition that can cause hypertension reported regularly checking their blood pressure. Also, only 61.6% of these individuals said their physicians advised them to periodically check their blood pressure.

The study authors suggested that “the decrease of in-person office visits with increased telehealth” could be the reason why less than two-thirds of clinicians recommended self-monitoring.

While around 75% of the participants reported having a device to monitor their blood pressure, some reported not using it and others said that while they use their device, they do not share the information with their doctors.

Self-monitoring blood pressure is important

The survey findings emphasize the need for people to be more aware of their blood pressure and to improve doctor-patient communication.

Since hypertension affects people of all ages and has the potential to be deadly if it is allowed to get out of control, it is a relatively easy health metric to track that can potentially be life-saving.

Dr. Anjali Dutta, a cardiologist with Morristown Medical Center at Atlantic Health System in Morristown, NJ, who was not involved in this study, spoke to Medical News Today about the review. Dr. Dutta said, “this is a good study that allows patients to participate in their own health.”

When asked why she thinks less than half of the participants self-monitor their blood pressure, Dr. Dutta said, “many patients may not be able to check their blood pressure due to busy work schedules or may have limited resources and cannot afford a blood pressure monitor.”

Dr. Vicken Zeitjian, a cardiologist who was also not involved in the study, also spoke with MNT about the survey findings and speculated on why people may not check their blood pressure.

“High blood pressure is often asymptomatic unless extremely high (described as ‘a silent killer’), hence many patients do not feel the need to check since they do not feel any different,” commented Dr. Zeitjian.

Dr. Zeitjian also pointed out that sometimes doctors do not recommend patients check their blood pressure regularly if it is within a healthy range in the office.

“The concept of hypertension is put aside,” Dr. Zeitjian continued. “However, the caveat is that blood pressure fluctuates throughout the day with activity, diet, and stress levels. It is important to have an idea of the average blood pressure throughout the day as opposed to seldom spot checks at a doctor’s office.”

Dr. Zeitjian also pointed to the rise of heart conditions in younger people, which emphasized the importance of self-monitoring blood pressure at all ages of adulthood.

“I recommend young adults to start and maintain a healthy lifestyle which reduces the risk for heart disease. While genetics is a predisposition we cannot control, there are a few things that are in our hands: diet, exercise (consistency is key), smoking cessation, alcohol limitations, and personal responsibility to monitor well-being. Annual physicals are important to ensure abnormalities are caught early and intervened upon before escalation of these chronic cardiac illnesses.”
— Dr. Vicken Zeitjian

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