1. Blood pressure is a major driver of vascular aging [1].
Permanently elevated blood pressure leads to a progressive change in vascular structure (known as remodeling). This specifically affects the function of the endothelium, the innermost layer of cells lining the arteries, which determines the ability of the vessels to relax. These changes are usually irreversible even with medication to reduce high blood pressure.
2. blood pressure measurement as an early warning system
- Blood pressure in young adulthood predicts impairments in brain function [2] Compared to adults who have been able to keep their mean blood pressure consistently low over 25 years, those with elevated or rising blood pressure have shown impairments in biomarkers of brain function and structure that are thought to influence mental functioning in old age.
- Early blood pressure monitoring in 20-year-olds helps detect and prevent hypertension risk @ 40 [3].
- Antihypertensive lifestyle measures can avoid future drug treatments [4].
3. home blood pressure measurement is more reliable than office measurement [5] [6].
Blood pressure is subject to natural fluctuations throughout the day. In addition, stress, diet, and other factors can affect blood pressure. Therefore, every blood pressure measurement should be seen as a snapshot. And this is precisely why it is important to use several measurements, at the same time of day and ideally under the same conditions, for a diagnostic assessment. This is not as easy to achieve in the doctor’s office as it is at home.
In addition, there are blood pressure phenomena that remain hidden from the physician’s view in the practice. These include white coat hypertension in people who only have high blood pressure in the doctor’s office. But the opposite is also known: People whose blood pressure is normal in the office but elevated at home, the so-called masked hypertension.
4. indispensable for effective therapy control [7]
For the same reason as explained in the previous point, only with daily monitoring of blood pressure is it possible to assess the effect of blood pressure-regulating interventions (whether lifestyle or medication).
5 Recommended by all cardiovascular societies [8] [9].
The automatic blood pressure monitors available today are suitable for laypersons and meet the requirements for measurement accuracy, so that all professional societies now expressly recommend blood pressure monitoring at home.
References
[1] Park J, Avolio A. Arteriosclerosis and atherosclerosis assessment in clinical practice: Methods and significance. Pulse 2023:1–14. doi:10.1159/000530616.
[2] Hu YH, Halstead MR, Bryan RN, Schreiner PJ, Jacobs DR, Sidney S, et al. Association of Early Adulthood 25-Year Blood Pressure Trajectories with Cerebral Lesions and Brain Structure in Midlife. JAMA Netw Open 2022;5:E221175. doi:10.1001/jamanetworkopen.2022.1175.
[3] Ridderstråle W, Saluveer O, Johansson MC, Bergbrant A, Jern S, Hrafnkelsdóttir TJ. Consistency of blood pressure and impact on cardiovascular structure over 20 years in young men. J Intern Med 2010;267:295–304. doi:10.1111/j.1365-2796.2009.02142.x.
[4] Hinderliter AL, Smith P, Sherwood A, Blumenthal J. Lifestyle Interventions Reduce the Need for Guideline-Directed Antihypertensive Medication. Am J Hypertens 2021. doi:10.1093/ajh/hpab090.
[5] Carey RM, Marwick TH. Which Blood Pressure Measurement Best Predicts Cardiovascular Outcomes?* n.d. doi:10.1016/j.jacc.2020.10.031.
[6] Schwartz JE, Muntner P, Kronish IM, Burg MM, Pickering TG, Thomas Bigger J, et al. Reliability of Office, Home, and Ambulatory Blood Pressure Measurements and Correlation With Left Ventricular Mass 2020. doi:10.1016/j.jacc.2020.10.039.
[7] Mengden T, Weisser B. Therapieüberwachung bei arterieller Hypertonie. Dtsch Arztebl Int 2021;118:473–8. doi:10.3238/arztebl.m2021.0158.
[8] Stergiou GS, Palatini P, Parati G, O’Brien E, Januszewicz A, Lurbe E, et al. 2021 European Society of Hypertension practice guidelines for office and out-of-office blood pressure measurement. J Hypertens 2021;39:1293–302. doi:10.1097/HJH.0000000000002843.
[9] Shimbo D, Artinian NT, Basile JN, Krakoff LR, Margolis KL, Rakotz MK, et al. Self-Measured Blood Pressure Monitoring at Home: A Joint Policy Statement From the American Heart Association and American Medical Association. Circulation 2020;142:e42–63. doi:10.1161/CIR.0000000000000803.
