Learn to actively manage hypertension

It's all about the three E's - education, empowerment and some easy-to-use equipment - once you've been diagnosed with high blood pressure.

But a surprising number of folks with hypertension fail to take an active role in managing this silent killer.

"I don't think a lot of people see the importance of it. They don't understand the relationship between blood pressure, medication and the repercussion of high blood pressure to their health," said nurse Linda Rose, manager of clinical operations for Alexian Brothers Home Health Care.

This summer three major medical groups - the American Heart Association, the American Society of Hypertension and the Preventive Cardiovascular Nurses Association - joined forces to urge consumers to become do-it-yourselfers in blood pressure monitoring. The new recommendation was published in the July issue of The Journal of Hypertension.

To be sure, elevated blood pressure is a tricky varmint. Our blood pressure changes from hour to hour, sometimes even minute to minute. That ubiquitous white coat syndrome - the tendency for people's blood pressure to spike when they're being checked in a health-care setting - makes it more likely for us to get a normal reading when we're at home.

Achieving a targeted blood pressure reading is also difficult. Experts believe that patients are likely to achieve targeted goals quicker and gain confidence in their blood pressure medications if they take an active role in monitoring it. Using a blood pressure monitoring device is something we really can do and should do at home, urge local health care experts.

"Measuring your blood pressure is a good habit and allows you to be active in managing your own health care plan," Rose said.

The first step is to find your real blood pressure. That reading you get in the doctor's office is just one chapter of your blood pressure story. While up to 20 percent of folks diagnosed with high blood pressure have white-coat hypertension, others have masked hypertension - a normal reading in a health-care setting but one that spikes everywhere else, according to a report in September's Harvard Health Letter.

Working with your physician on getting an authentic reading is key. Buy a reliable, easy-to-use home blood pressure monitor - there are dozens on the market.

The American Heart Association does not recommend wrist or finger monitoring models. September's issue of Consumer Reports compares such monitors and rated the ReliOn HEM-74CREL (about $50), as a best buy and the Omron Elite 73000W ($75 to $100) as the top-rated machine.

"Select a moderately priced unit," advised Rose. "A unit that costs more money doesn't necessarily mean it's a better unit."

Digital models are easier to read, easier to manage and good for someone who is hearing-impaired. But accuracy is sometimes a disadvantage, since readings can be affected by body movement or irregular heart rates.

Make sure your machine is in tune with the one in the doctor's office. Then once a year, take it to your physician or nurse for a "checkup." Many local fire departments can also do an accuracy test.

The right size cuff is important, Rose said. A cuff that's too loose or too tight distorts the reading.

Ask your physician what size they use for your reading. Always check blood pressure the same time of day for consistency. Many experts suggest taking your blood pressure an hour or two after you take medications. The Harvard Health Letter recommends taking an initial reading early in the morning before you take blood pressure pills and another reading in the evening every day for a week. After that, follow the plan recommended by your doctor.

The Harvard Heart Letter also suggests:

• Avoid caffeinated or alcoholic beverages.

• Don't smoke in the 30 minutes before you measure your blood pressure.

• Sit quietly for five minutes with your back supported and feet on the floor. When taking your reading, support your arm so your elbow is at the level of your heart. Push your sleeves out of the way and wrap the cuff over bare skin.

Don't panic if you get a high reading. Just relax a few minutes and try again. Keep a record of your blood pressure readings and the time of day they are made. "Keeping a log can be a good way to recognize your dietary slips," Rose said. "We teach our patients to monitor their blood pressure daily in the hopes that they will become an active participant in their health care plan and understand how their diet and medication compliance can affect their readings."