Posted by: notdeaddinosaur | December 6, 2012

The Home BP Monitoring Factor

High blood pressure is the number one killer in America today, when you consider it the root cause of virtually all cardiovascular disease (heart attacks and strokes). The reason hypertension is such an insidious killer is that it is completely asymptomatic. Many people are convinced that they can tell when their blood pressure is high. They are wrong, It is impossible to tell what the blood pressure is by any subjective measure.

The only way to know your blood pressure is to measure it.

I can do it in the office. You can do it at home. Not all portable home blood pressure monitors are reliable, though. That’s why I recommend that patients who monitor their blood pressure at home bring their machine into the office to calibrate them with my equipment.

When my patients check their blood pressure at home, I also ask them to write down the results and to bring their record along with them to office visits. It’s the best way to see how well their blood pressure medication is really working.

Which brings me to a memorable moment:

Patient in her 70s with hypertension, with somewhat elevated office readings. I asked her to monitor her pressures at home, which she did. She then brought her machine and her readings in with her one visit.

I was perusing her numbers, and noticed that they were generally pretty good; 110s to 120s over 70s to 80s. Except for one or two evening readings of 154/98 and 160/100. Before I could so much as raise my eyebrows, she pointed them out herself.

“You can’t count those,” she said. “Those were while I was watching Bill O’Reilley.”




  1. great post.
    I will add a similar story…
    I visited a 95yo in her home because daughter complained of sudden onset of aggitation, anxiety, and “just being mean.”
    I had seen her their many times and she had always been sweet and pleasant and usually listening to the local classical music station when I arrived.
    On this day however, I arrived to find her watching Fox News and a brand new large flat screen TV that her son had bought her.
    Before I could even say hello, she went into a 10min rant about how the “country is going to hell, and it’s all Obama’s fault!”

    I was pretty sure I knew what was causing the new sense of anxiety and asked how much she was watching the TV news during the day. She promptly said. “all day except for 2 hrs when I listen to Rush!”

    I wrote a script for no more than 1hr of TV news a day and back to classical music.

  2. I was monitoring at home with a not cheap wrist monitor and when I tried to bring it in to see if it matched the office readings I was not given the chance – before even seeing it or trying it all of those I asked dismissed it as worthless and told me to get a different one.

    I did buy a new (not cheap) one and havent checked my BP beyond the first time. The new monitor is too big to hide and brings too much medical into my home. Chronic illness sucks enough as it is without the constant reminders.

    I’m pretty sure my resentment towards it isnt helping my BP.

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