| Indeed, it might be useful for you to measure your | | | | Unfortunately, not all doctors agree that people |
| own blood pressure at home. Home measurements | | | | should do their own measurements at home. Many |
| have the great advantage that they can be done | | | | specialists and some general practitioners disagree |
| when you are relaxed and unflustered and that you | | | | with home readings. These doctors either suggest |
| can do them as often as you like, without worrying | | | | that it is not possible for people to learn to measure |
| about taking up your doctor's or your nurse's time. | | | | their own blood pressure accurately or, alternatively, |
| They are usually lower than measurements taken in | | | | that the procedure will frighten people and make |
| hospitals, but little different from measurements | | | | some of them obsessed with excessively accurate |
| taken in a general practice's surgery by a doctor or | | | | control of their blood pressure. There is now a |
| practice nurse. | | | | handful of published research evidence on this topic |
| Many general practice teams now like to have 28 | | | | and all of it supports the view that any literate |
| home measurements (usually made twice daily | | | | person who can drive a car, use a typewriter or |
| everyday for two weeks) before starting treatment, | | | | word processor or understand how to use a |
| especially in borderline cases. They are extremely | | | | programmed electric cooker or washing machine is |
| useful early on, before any treatment starts, mainly | | | | certainly able to measure blood pressure as |
| in order to decide whether to start treatment now, | | | | accurately as any doctor or nurse and possibly better |
| or whether to wait for a while to see if your | | | | than many. It also shows that for nearly everyone |
| apparently high blood pressure is sustained. | | | | who wants to do these measurements themselves, |
| Most people have no problems with taking their own | | | | anxiety is thereby reduced, not increased. Anxiety |
| blood pressure measurements accurately once they | | | | does increase in about 5 percent of people, but only |
| have had some basic training and practice. On the | | | | if they are pushed into doing measurements against |
| other hand, a few people may have difficulty. People | | | | their own inclination. |
| with an irregular pulse caused by atrial fibrillation (a | | | | Home measurements are probably less useful for |
| condition characterized by quivering of the upper | | | | follow-up once treatment has started. Nobody with |
| chamber of the heart instead of pumping in an | | | | blood pressure high enough to need medication, not |
| organized way) or frequent extra heartbeats may | | | | even doctors or nurses, should attempt to manage |
| produce lots of odd sounds at levels above systolic | | | | their problem entirely alone. Medical decisions about |
| and below diastolic blood pressure, so it may be | | | | starting, changing, interrupting or stopping treatment |
| impossible for them to take an accurate blood | | | | need to be made objectively, against a background |
| pressure measurement. The best anyone can do in | | | | of experience with many other cases and knowledge |
| these cases is to make a rough estimate of the level | | | | about other complicating risks. Such judgment is not |
| at which sounds appear and disappear. There are also | | | | possible for a person with high blood pressure acting |
| a few people in whom sounds are still audible down | | | | alone, however much they may know. Home |
| to 0 mmHg, which again makes accurate readings | | | | measurements of blood pressure can be useful in |
| extremely difficult. Many of these can get a diastolic | | | | follow-up, if they add to the evidence normally |
| pressure by removing all clothing from their arm, or | | | | available to a blood pressure clinic, but they cannot |
| sometimes by using the other arm. | | | | replace regular skilled and independent advice. |