Get a 24-Hour Blood Pressure Reading to really know your heart health

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  • High blood pressure (hypertension) is a warning sign of multiple health issues.
  • A new study finds that the best way to determine a person’s heart health is to look at their blood pressure over 24 hours.
  • This method could offset “white coat hypertension,” where the stress of going to the doctor’s office can increase a person’s blood pressure.

Heart disease is the leading cause of death in the United States, accounting for nearly 1 in every 4 deaths — or about 610,000 deathsTrusted Source — each year.

It’s also the most expensive disease, costing the country nearly $1 billion each day.

The vast majority of cardiovascular disease cases are preventable, had people received earlier diagnoses and treatments.

One way to detect signs of cardiovascular disease is a simple blood pressure reading.

High blood pressure (hypertension) has long been known to be the biggest — and most treatable — risk factor associated with diseases of the heart and vascular system. But many people don’t know they have it until it’s too late, according to the Centers for Disease Control and Prevention (CDC)Trusted Source.

Now, researchers have discovered a new way to get more accurate measurements of blood pressure, which can hopefully get people on the right medications sooner and help prevent cardiovascular disease.

By recording people’s blood pressure over 24 hours rather than just once in a clinic or hospital setting, doctors can more accurately diagnose high blood pressure and effectively predict someone’s risk for heart and vascular disease, according to a new international study recently published in JAMATrusted Source.

To determine the most reliable way to measure blood pressure, researchers followed 11,135 people from Europe, East Asia, and Latin America for 14 years.

They compared the accuracy of blood pressure readings that were taken in a medical setting to blood pressure recordings that were taken during both night and day over 24-hour periods.

The researchers found that the 24-hour and nighttime blood pressure measurements provided a more accurate estimate of one’s risk for heart and vascular disease compared to the in-office readings.

“Although heart and vascular disease are strongly associated with blood pressure, irrespective of how it is measured, until now we did not know which type of blood pressure measurement captured risk in the most accurate way,” study co-author Dr. Gladys Maestre, a researcher from the University of Texas, Rio Grande Valley School of Medicine, said in a statement.

The findings suggest that blood pressure should be monitored repeatedly for 24 hours to help diagnose people’s heart issues and, ultimately, prevent cardiovascular disease, according to the researchers.

“Ever since devices to measure blood pressure were invented more than 100 years ago, it’s been known that elevation of such readings predicted the eventual development of blood vessel disease, heart attack, stroke, heart failure, and kidney dysfunction,” says Dr. Richard Wright, a cardiologist at Providence Saint John’s Health Center in Santa Monica, California.

In general, the further a person’s blood pressure readings deviate from the ideal, the more likely they are to eventually develop any of these health issues, Wright added.

However, a huge issue comes into play when blood pressure is measured in a healthcare setting.

Many people have elevated blood pressure readings due to anxiety of being in a medical environment — known as the white coat effect — and those high readings don’t accurately reflect a person’s overall blood pressure levels.

“Unfortunately, blood pressure isn’t a fixed number for any individual and varies widely over each day, being much higher during stress or physical exercise, and typically lowest at night during asleep,” he explained.

Even the stress of having a blood pressure cuff put on the arm or seeing a doctor walk into the room can cause some people’s blood pressure to spike, he added.

Repeated monitoring can better predict your risk

Twenty-four hour monitoring can look at a person’s blood pressure fluctuations throughout an entire day rather than at a given moment.

There’s also a huge advantage of measuring blood pressure during sleep because the results aren’t affected by daytime meals or activities.

“Ambulatory monitors give us a great sense of what the patient’s blood pressure is doing in real life as well as when they are sleeping, when it should decrease,” Dr. Nicole Harkin, a board-certified cardiologist and lipidologist with Manhattan Cardiovascular Associates in New York City, said.

“They also give us a large data set of blood pressures to look at, as opposed to a one-time snapshot in the doctor’s office, which is subject to many variables, including errors in measurement as well the patient’s recent activity level, medication timing, and inadequate rest prior to measurement,” she said.

According to Harkin, the current American College of Cardiology and American Heart Association blood pressure guidelines support the use of ambulatory blood pressure monitoring to better predict cardiovascular outcomes.

Coverage for ambulatory blood pressure monitoring varies across different insurance providers. Much of the time, it’s only covered for people who experience white coat hypertension, in which an individual’s blood pressure is higher in a doctor’s office than it would normally be, she explained.

Seeing as ambulatory blood pressure monitoring can better predict long-term heart disease outcomes, healthcare providers should place a greater emphasis on 24-hour readings than those taken in a doctor’s office.

If people know their blood pressure is higher than it should be, the better they can manage it to minimize the odds they’ll develop heart disease down the road.

High blood pressure can be the biggest predictor of heart disease, so the sooner people can start managing their blood pressure, the lower their risk of heart and vascular disease may be.

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