What are the disadvantages of taking blood pressure in hospitals?
What are the drawbacks of hospital blood pressure testing? We patients are often convinced that the blood pressure measured in the hospital is more accurate than the blood pressure measured at home, but the truth is the opposite, because the human blood pressure is dynamic, easily affected by the environment and emotions, the blood pressure measured in the hospital once or twice is likely to produce deviations, or even “masked hypertension” and There are even cases of “masked hypertension” and “white coat hypertension”.
What is “masked hypertension”?
”Masked hypertension” is concealed hypertension, in which the patient’s blood pressure is “secretly high”, and the patient’s blood pressure is not high when measured in the hospital, but is higher than normal when leaving the hospital. Some studies have shown that this “masked hypertension” patients actually up to 14%. Masked hypertension is true hypertension, but it is often overlooked and underdiagnosed.
What is “white coat hypertension”?
White coat hypertension” is the opposite of “masked hypertension”, which means that some patients become nervous when they see a doctor in a white coat, and there are too many catecholamines in the blood, making the heart beat faster, and also making the peripheral blood vessels contract and increase resistance, producing the so-called “white coat effect”. “white coat effect”, which leads to a rise in blood pressure. These people do not necessarily have true hypertension and may not require medication.
To identify whether this hypertension is true or false, it is necessary to rely on 24-hour ambulatory blood pressure or blood pressure measured at home.
Ambulatory blood pressure: accurate but with limitations
The blood pressure data from a single measurement at the hospital is not enough to explain the problem, so there is ambulatory blood pressure measurement, which can observe changes in blood pressure over a 24-hour period, and can also detect white coat hypertension, covert hypertension, etc. The measurement of blood pressure is more accurate, with no human error. However, compared to home self-measurement of blood pressure, its equipment is less operable and repeatable, more expensive, and generally community hospitals do not have this instrument, which cannot be widely used at present.
Measuring blood pressure at home: recommended by doctors in outpatient clinics, I found that one of the important reasons for the low rate of hypertension control is that the general public does not know their blood pressure, or the measurement method is not standardized. Even many hypertensive patients use medication based on their feelings alone. For some special hypertensive patients, such as elderly hypertension, refractory hypertension and pregnant women, it is important to beware of not only sudden rise in blood pressure, but also hypotension in cases such as excessive hypotension or fluctuations in blood pressure itself. Therefore, it is advisable to have a blood pressure monitor for self-measurement of blood pressure at home.
Self-measurement of blood pressure at home will become mainstream
In 2011, both NICE and Canadian guidelines recommended ambulatory blood pressure measurement and home blood pressure measurement as the basis for hypertension diagnosis. 2014 Japanese hypertension guidelines emphasize for the first time that home blood pressure measurement is the priority for hypertension diagnosis, and when there is a difference between hospital blood pressure and home blood pressure diagnosis, home blood pressure diagnosis is preferred.
Advantages of self-measurement of blood pressure at home
1, home blood pressure measurement is more operable
Patients can measure blood pressure at home with higher frequency and sensitivity, and it is repeatable and traceable.
2, home blood pressure measurement can improve the patient’s blood pressure management enthusiasm
Patients will only be motivated to match and treat their blood pressure if they know their own blood pressure status. When patients are motivated to control their blood pressure, the communication between doctors and patients will be smooth, and the patients’ compliance with treatment will be improved.
3, home blood pressure measurement lower cost, more convenient monitoring
Home blood pressure measurement and ambulatory blood pressure can identify white coat hypertension and hidden hypertension, but home blood pressure measurement is cheaper and can help assess the effectiveness of hypertension treatment, which is an economical and easy-to-operate way to measure blood pressure.
This is how to take blood pressure at home to measure accurate
1.What blood pressure monitor to use?
Home self-measurement of blood pressure is recommended to use the international standard certification of the upper arm type electronic blood pressure monitor; generally not recommended finger type, wrist type electronic blood pressure monitor.
2, these factors can lead to blood pressure deviation.
How much of the home self-measurement blood pressure is up to standard?
Blood pressure measured at home differs somewhat from that measured in a hospital, and usually the former is about 5 mmHg lower than the latter. 135/85 mmHg measured at home is equivalent to 140/90 mmHg measured in a hospital.
If the blood pressure measured at home at different times and several times is ≥135/85 mmHg, the diagnosis of hypertension can be considered.
1, The frequency of measurement varies from patient to patient
2.Patients with hypertension whose blood pressure does not reach the standard and is unstable: measured for 7 consecutive days, once daily in the early morning (6:00-10:00) and once in the evening (18:00-21:00).
3, blood pressure standard and stable hypertensive patients: measured 1-2 days a week, once in the morning and once in the evening.
Note: morning blood pressure measurement is best after urination, before breakfast and before medication.
After mastering the skill of how to measure blood pressure at home, you will not be afraid of inaccurate data measured at home, patients should also actively communicate with their doctors about their blood pressure data measured at home, so that masked hypertension is nowhere to hide!