More people should be regularly checking their blood pressure at home, research suggests.
More than half of adults between the ages of 50 and 80 have a health condition that puts them at high risk of major health emergencies if they don’t keep their blood pressure under control. A new poll finds less than half of people in this group regularly check their blood pressure outside the health care system.
Even among people with such health conditions who said their health providers encouraged them to check their blood pressure regularly, only about two-thirds actually did.
Exploring the reasons why and finding ways to prompt more people with these health conditions to check their blood pressure regularly could play an important role in helping patients live longer and maintain heart and brain health, the poll’s authors say.
Past research has shown that regular home monitoring can help with blood pressure control, and that better control can mean reduced risk of death and cardiovascular events, including strokes and heart attacks.
Uncontrolled high blood pressure
A report on the findings comes from the National Poll on Healthy Aging (NPHA), which asked older adults about their chronic health conditions, blood pressure monitoring outside of clinic settings, and interactions with health providers about blood pressure.
Brain health “is an under-appreciated effect of good blood pressure control, and one that could be very motivating…”
The new poll report focuses on responses from the 60% of the poll respondents who said they were either taking a medication to control their blood pressure or had a chronic health condition that requires blood pressure control—specifically, a history of stroke, coronary heart disease, congestive heart failure, diabetes, chronic kidney disease, or hypertension (also called high blood pressure).
“For people with these chronic health conditions, having uncontrolled high blood pressure can substantially increase the risk of death, stroke, heart attack, diabetes complications and kidney failure. That’s why national guidelines call for them to check their blood pressures regularly,” says Deborah Levine, a blood pressure researcher at the University of Michigan who worked with neurologist Mellanie V. Springer and the NPHA team to design, analyze, and report findings from the poll. The poll is based at the University of Michigan Institute for Healthcare Policy and Innovation.
“The more that people with these health conditions can monitor their blood pressure between appointments with their doctor, nurse practitioner, or other provider, and share readings digitally or over the phone, the more information their provider will have to counsel and treat them,” says Springer.
Who has or uses a blood pressure monitor
In all, 74% of the older adults with blood pressure-related conditions said they had a home blood pressure monitor. Adults who owned a blood pressure monitor were much more likely to measure their blood pressure at home than those who did not own a monitor.
But less than half of those with both a blood pressure-related health conditions and a home blood pressure monitor check their blood pressure at least once a week. Nearly one-fifth—19%—never use the monitor.
Among those who check their blood pressure at home regularly, 50% share the readings with a health provider.
Among those with blood pressure-related health conditions who did not own a home blood pressure monitor, 54% said it was because they didn’t need it or had never considered it.
Good blood pressure protects cognition
National clinical guidelines, which are based on medical evidence and aimed at doctors and other providers to help guide their practice, call for regular home blood pressure monitoring for people with conditions such as the ones the poll asked about. But only 62% of poll respondents with these chronic health conditions said that a health provider had ever told them to measure blood pressure at home.
When the poll team looked further at the responses from this group, they found that adults who were ever told by a health provider to check their blood pressure periodically were more than twice as likely to check blood pressure at home than those who were not told.
A doctor’s recommendation was cited as a reason for home monitoring by 51% of poll respondents who had a blood pressure-related condition and checked their blood pressure at home regularly. Other motivations for checking blood pressure at home included the most common response of wanting to be as healthy as possible (mentioned by 60%) and the least common response of wanting to prevent a decline in their cognitive ability such as memory and thinking (13%).
This suggests that providers need to emphasize brain health to patients with blood pressure-related conditions. Monitoring and keeping their blood pressure under control can help the brain, as well as heart and kidney health.
“This is an under-appreciated effect of good blood pressure control, and one that could be very motivating if older adults understood the link,” says poll director Preeti Malani, a medical professor with training in both geriatrics and infectious diseases. She notes that an earlier NPHA poll found few older adults had spoken to their doctor about preventing dementia.
Support for the work came from the AARP and Michigan Medicine, the University of Michigan’s academic medical center.
The National Poll on Healthy Aging results are based on responses from a nationally representative sample of 2,023 adults aged 50 to 80 from the Ipsos KnowledgePanel who answered a wide range of questions online in January 2021. Questions were written, and data interpreted and compiled, by the IHPI team.
Source: University of Michigan
