At the Palms Surgery we are now promoting home BP readings as a means of assessing suitability for treatment or the need to change doses of medications if the diagnosis is established. High blood pressure (hypertension) is a common problem, and there is overwhelming evidence to support the benefit of reducing high blood pressure in reducing your risk of stroke, heart disease and death.
Most BP machines that go around your upper arm are accurate enough to measure BP. The British and Irish Hypertension society have produced a list of accredited machines and you can find it here and if purchasing a new machine we recommend that you get one from this list.
Traditionally, blood pressure measurement has been done at the surgery, but recently electronic home blood pressure (BP) recording machines have become widely available and with COVID curtailing services we are now asking people to take home readings if possible. Home readings have the following benefits:
- A greater number of recordings gives a more accurate average ‘true’ blood pressure, to determine if treatment is required or needs adjusting.
- The patient can more empowered and informed about their healthcare.
- Most peoples blood pressure is bit higher in the doctor’s office than when patient is at home. Taking your BP measurement at home removes the element of ‘white coat hypertension’ that affects some people more than others.
Are there any disadvantages? There may be:
- The evidence we use to determine the thresholds for defining high blood pressure is traditionally based on doctors’ office measurements—the evidence for home readings may yet change.
- There is a risk of over-medicalising the issue and causing some people too much anxiety about their blood pressure. Everyone’s blood pressure varies naturally during the day. We would ask that you take some readings when asked by your doctor but try and avoid taking it too frequently as can cause some worry.
Some people don’t want to or are unable to perform home blood pressure readings—that’s fine, this is purely optional.
What to do
- Obtain a validated machine as advised above.
- You can record your readings on the charts below. The Excel spreadsheet will calculate your average blood pressure for you.
- Please bring a copy of one or other record to your consultation or ensure that they are sent to the surgery via email prior to the review by the GP.
How do I take my blood pressure?
Please follow the instructions with the machine. Note the instructions regarding cuff size (you may need to buy a large cuff), positioning (seated, legs uncrossed, back and arm supported) and getting used to the machine with several measurements before recording them.
Ambulatory Blood Pressure Monitoring (ABPM)
If your results are abnormal and persistently elevated we can offer to do an ABPM. The nurse can fit you with a special new BP machine which you wear for 24 hours, then return the next day. It checks your BP every 30 mins, and we can download the data from it to calculate your average blood pressure. It may be that this is more accurate than home readings over a week, although will require you to attend the surgery on consecutive days.
Speak to your GP if you wish to arrange an ABPM. It is free for medical card holders but there is a charge of e40 for private patients.
Other than medication, what else can I do to help my blood pressure?
This depends on the level of blood pressure and other risk factors for heart disease and stroke such as whether you smoke, have raise cholesterol, diabetes or a worrying family history. We will discuss these during your consultation before we agree on the best course of action for you.
Lifestyle measures that have been shown to reduce blood pressure include:
- Regular exercise
- Not drinking alcohol excessively
- Reducing caffeine intake
- Reducing salt intake
- Stopping smoking
What do I do now?
Record your BP readings on our downloadable form or on the Excel Worksheet provided. The Excel worksheet will automatically calculate your average BP. If you use the downloadable form we would ask you to calculate the average BP and submit this reading to us to save us time.
Send the results to us in the surgery.
You can either email the average BP reading and a copy of the form to firstname.lastname@example.org or complete the BP diary contact form below and this will be sent to the surgery. Please contact the surgery to ensure the doctor has received the results and also to arrange follow up and review if required.