Most medical experts agree that 24-hour ambulatory blood pressure monitoring is the most effective way to measure blood pressure and dangerous hypertension. The patient wears the device all day and during sleep to measure how his or her blood pressure responds to various situations.
In a six-month period, according to one study, ambulatory monitoring led to less intensive medication therapy and better control of blood pressure.
Ambulatory monitoring is relatively expensive, however, and a Treatment of Hypertension Based on Home or Office Blood Pressure study found that home monitoring also resulted in less intensive drug therapy and lower medical costs.
Home monitoring is endorsed as a better alternative to ambulatory monitoring by the U.S. Joint National Committee and the European Society of Hypertension.
BP control essential for diabetics
From 55 percent to 65 percent of Americans with diabetes also have high blood pressure, and it increases their risk for cardiovascular disease. According to the Hypertension Optimal Treatment study, subjects following intensive control of blood pressure had 51 percent fewer heart attacks, strokes and other cardiac-related events.
The American Diabetes Association recommends a blood pressure goal of 130/80 or lower for diabetics.
Buying a home BP monitor
When you're buying a home blood pressure monitor, look for the seal of the Association for the Advancement of Medical Instrumentation, the group responsible for testing and setting standards.
There are many high-quality monitors on the market, ranging in price from $10 to $125, depending on features they offer.
"White coat effect" and its reverse side
In what is known as the "white coat effect," some individuals have higher blood pressure when it is recorded by a doctor or nurse. To account for this effect in determining treatment, patients often are asked to carry an ambulatory monitor for 24 hours or to make numerous recordings of a home monitor. The idea is to record blood pressure throughout the day with various activities.
On the other hand, one study found significantly higher readings at home than in a doctor's office - presumably because of faulty technique or anxiety about the act of measuring blood pressure.
Confidence in FDA declines
Amid the controversy surrounding COX-2inhibitors and other prescription drugs, a survey of 1,000 Americans found that confidence in the Food and Drug Administration has declined and that a majority would like to see the FDA's regulatory powers either increased or kept at current levels.
Weeding out risky foods
When tested, about 50 percent of conventionally grown produce and even some organically grown products show pesticide residues. In all cases, the amount is small enough that regulatory bodies do not consider it a health threat.
According to the Environmental Working Group, foods most likely to be contaminated, in descending order of toxicity, are: strawberries, bell peppers and spinach (tied for second), U.S. grown cherries, peaches, Mexican cantaloupes, celery, apples, apricots, green beans, Chilean grapes and cucumbers.
This nonprofit group recommends seeking organic sources for such foods, if possible. The group found the lowest levels of pesticides on avocados, sweet corn, bulb onions, cauliflower, asparagus, Brussels sprouts, U.S. grapes, bananas, plums, scallions, watermelon and broccoli.