Q & A Library

Several medical organizations, including the American Heart Association, have recommended that everyone who has high blood pressure invest in a home monitor to perform regular checks. This was proposed because only one-third of the 72 million Americans who have high blood pressure have it under control. Frequent monitoring - by patients, at home - gives doctors a more realistic idea of the range of a patient's blood pressure and shows more clearly how pressure is responding to medication. More frequent monitoring than is possible with visits to doctors' offices also facilitates fine tuning of drug dosages, as well as revealing the effects of such lifestyle measures as weight loss, exercise, and limiting salt intake.

There is precedent for this type of home testing: for years, people with diabetes have been monitoring their blood sugar with home devices. Blood pressure monitors for home use cost from $50 to $100. You can get them at drug stores and online. The groups that recommend them have also called upon insurers to pay for monitors prescribed by physicians. If you buy one on the advice of your physician, you'll have to bring it into the office so its measurements can be compared to those obtained there.

Your suspicion that this recommendation may have been influenced by manufacturers of the home monitors has been voiced elsewhere. Experts who think home monitoring is a great idea have said that the recommendation would be more compelling if one of the leading manufacturers of the monitors didn't support the American Heart Association's blood pressure Web site to the tune of $300,000 to $400,000 per year. (However, that amount is only a small fraction of the AHA's $800 million annual revenues.)

Instead of focusing on the unfortunate issue of industry ties, I would look at the individual benefits home monitoring can make possible. These include a clearer idea of your blood pressure, better medical management, and, perhaps, motivation to make the lifestyle changes that can help: losing weight, increasing exercise, practicing relaxation methods, and reducing salt intake.

Andrew Weil, M.D.