Harvard Heart Letter

Heart Beat: Treat yourself to better blood pressure

If your already high blood pressure starts to drift upward, do you really need to see your doctor to get it back under control? Maybe not. Results of a trial show that a carefully planned do-it-yourself approach can work as well as trips to the doctor's office.

In the Telemonitoring and Self-Management in the Control of Hypertension Trial, half of the 527 volunteers checked their blood pressure every morning and electronically transmitted the results to their doctors. If their pressure steadily began to rise, they adjusted their medications using a prearranged strategy. The other half had their pressure checked in their doctors' offices, and the doctors made all medication decisions. After a year, systolic blood pressure (the top number of a blood pressure reading) had fallen almost 18 points in the home monitoring and self-management group, compared with 12 points in the usual care group (The Lancet, July 17, 2010). In a large group of people, an extra 6-point reduction in blood pressure would translate into a 20% reduction in stroke and a 10% reduction in coronary artery disease.

Checking blood pressure at home and adjusting medications isn't for everyone with high blood pressure — or for all of their doctors. But if you have the interest and the savvy to do it and a doctor who is game to help, this strategy could improve your blood pressure and save you several trips to the doctor's office.

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