Wednesday, September 08, 2010


I have been asked very often to explain the importance of self BP monitoring. So I decided to write about it.
Obesity and stress are two very common problems in our hassle and bustle society. We are in a rat race, running around all the traffic jams like trapped rats. Tension and hypertension is becoming more and more common. That is probably why more and more people are buying digital BP sets to self monitor. That also means that many companies are selling ( direct sells ) of BP sets ( mostly digital ) to the public. This is not necessarily a bad thing. Creating awareness is always good. It helps prevention. The professional bodies, like the American Heart Association and the European Hypertension Society, have gone ahead to formulate guidelines for early management of even " pre-hypertension ".
The problem is that blood pressure is also a very labile entity. It rises and falls with tension and the state of mind. It is very suggestible. If you feel tension, it is very likely that you will record hypertension, which when you have less ( or no ) tension, the blood pressure may become normal rather quickly. That is just labile hypertension and not true hypertension.
Therefore, how and when you take your BP when you have a machine, and is self-monitoring, is rather important.
I always discourage my patient from spot checks when they feel tension and unwell. The chances are that the BP will be high and that drives subsequent BPs higher ( self fulfilling ). Avoid that if possible. If you are not well, see your friendly GP and get a proper assessment.
Firstly, for those who are self monitoring their BP with one of those digital machines, remember that those digital machines have IC circuits, must be properly stored and may need repeated calibration, almost every year or two years. The old fashion mercury column machines ( the one in the doctor's clinic ) is very hardy and does not require such frequent calibration.
Secondly, take the BP at the same regular hour every day as a routine. Sit down for 5 mins, try to relax before inflating the machine. Take it three times a day, say morning after wash-up, evening when you return after work and at night before bedtime. That day's BP will then be the average of the three recordings. Keep a record book. You will find that the morning readings will be the highest ( morning surge ) as our BP through-out the day also have a certain circadian cycle. We like all average readings to be 130/80mmHg or less.
Any reading between 130/80 - 140/90 mmHg should make you aware that you need life-style modification ( mainly, no added salt in food, alot of green veges and fruits, lose weight and have regular exercise ). Any reading consistently beyond 140/90 mmHg, should be brought to the attention of your family doctor.
Prevention is better then cure. Hypertension is a chronic lifestyle disease and the management must begin with life style modification.

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