A third of adults in the United States already have high blood pressure. Many more have not been officially diagnosed and may be made to wear ambulatory blood pressure monitors for confirmation if draft recommendations by the U.S. Preventive Services Task Force are approved.
These recommendations were based on results from a review published in the journal Annals of Internal Medicine, providing the task force with evidence that ambulatory blood pressure monitors aid in avoiding overtreatment and misdiagnosis of hypertension. Ambulatory blood pressure monitors involve wearing a pressure cuff constantly for a day or so. The cuff will automatically inflate at intervals to closely match fluctuations in blood pressure and data will be stored in a monitoring device.
To give doctors a better idea of how a patient's day is typically carried out, activity diaries are also kept. This allows for more accurate assessments of whether or not a person is truly hypertensive.
According to a review, wearing an ambulatory blood pressure monitor was 40 percent better at warning against future heart disease, strokes and heart attacks compared to blood pressure checks individually done at a doctor's office.
It would work extremely well on those suffering from "white coat syndrome" that get nervous in medical environments, leading to a spike in blood pressure that may be inaccurately diagnosed as hypertension. With measurements done in comfortable surroundings, blood pressure levels are checked without external influences.
Those on the other end of the spectrum of "white coat syndrome" sufferers will also benefit from wearing ambulatory blood pressure monitors, experiencing lower blood pressure levels when they're in a medical setting. This is because those with naturally higher blood pressure usually take medications when undergoing a lot of stress at home or right before seeing their doctor.
To review measures for the Task Force, an analytic framework was developed from five key questions geared towards examining direct evidence regarding the pros and cons of screening for high blood pressure, the accuracy of methods for diagnosing high blood pressure, the ability of a measurement to predict cardiovascular events and diagnostic accuracy in non-office measurements.
If the recommendations are finalized, health insurance providers will be required to pay for the blood pressure monitors because approved preventive procedures are covered by the Affordable Care Act.
Supported by the Agency for Healthcare Research and Quality, the review was carried out by Margaret Piper, Ph.D., MPH, Evelyn Whitlock, M.D., MPH, Corinne Evans, MPP, Elizabeth O'Connor, Ph.D., Brittany Burda, MPH and Karen Margolis, M.D., MPH.
