Major new study supports 24-hour home blood pressure monitoring
Changing the way blood pressure is measured will save lives, according to scientists from University College London
Scientists from University College London and universities in Spain have found that measuring blood pressure using a technique known as 24-hour home ambulatory blood pressure monitoring (ABPM) is more accurate than measuring it in clinic and should be used to make decisions about treatment.
In the largest study of its kind, published in the New England Journal for Medicine this April, the researchers looked at the blood pressure measurements of 63,000 people and compared them to their risk of stroke or heart attack four years later. Blood pressure measurements were taken both in clinic using traditional hand held or automatic monitors and again using ABPM, and the latter was 50% more accurate and better at predicting health problems.
What is ABPM?
ABPM involves wearing a small blood pressure monitor around your waist for a day and night, taking readings every 20-30 minutes as you go about your daily life.
This study showed that it overcame white coat hypertension, where your blood pressure is raised due to the stress of being in clinic, and masked hypertension, where you have raised blood pressure but it appears to be normal in clinic.
Why is this study important?
Around a quarter of adults around the world have high blood pressure, and it's the leading preventable cause of premature death.
The team from University College London argue that traditional methods of testing for high-blood pressure are no longer adequate and risk missing vital health signs, which can lead to premature death, and ABPM should be used around the world to save lives.
Professor Bryan Williams of University College London, who lead the study, said:
“For decades doctors have known that blood pressure measured ‘in-clinic’ could be masked or elevated, simply because the patient was in a medical setting, and this could lead to the wrong or a missed diagnosis.”
“This research is a clear game-changer, as for the first time, it definitively shows that blood pressure measured regularly during a 24 hour period predicts the risk of heart disease, stroke and death much better than blood pressure measured in a doctor’s surgery or clinic.
“Quite simply, measuring blood pressure over 24 hours is what doctors and medics should be using to make clinical decisions about treatment.
“With a much more accurate assessment of a patient’s blood pressure, doctors will be able to provide the most effective treatments at the earliest opportunity, which will save many more lives.
“With one billion people around the world having high blood pressure, this study, the largest ever of its kind, should lead to changes in clinical practice across the world, with the use of ABPM becoming much more common place.”
Professor Graham MacGregor, Chairman of Blood Pressure UK says: "The findings from the study are very interesting – especially since blood pressure can be variable on its own and specific factors can change day-to-day readings.
People can also take action themselves to lower their blood pressure by eating less salt, more fruit and vegetables, taking more exercise and being a healthy weight. Even a small, 10 mmHg, reduction in systolic blood pressure significantly reduces the risk of major cardiovascular disease events; by 20% for Coronary Heart Disease, 27% for stroke, and 28% for heart failure, so anything you can do to lower your blood pressure will lower your risk."
Read more
Read the full analysis of the research from NHS Choices
Read the article in the New England Journal of Medicine