The World Hypertension League (WHL), an organization of national hypertension societies started in 2005 a worldwide campaign to increase awareness on hypertension.
May 17 of each year was dedicated as World Hypertension Day.
Due to the rapid increase in the number of persons affected, which is now about 1.5 billion worldwide, the economic impact and the health burden caused by high blood pressure, WHL and the International Society of Hypertension designated May as May Measurement Month. In our country, May is Hypertension Awareness Month.
Several surveys done in different countries have shown that people’s level of awareness of their blood pressure levels was low, even in rich and highly-developed countries.
Blood pressure can be measured using ambulatory blood pressure monitoring or ABPM, home blood pressure monitoring or self-measured blood pressure, standard manual clinic (office) blood pressure measurements, or automated clinic (office) blood pressure measurement using an automated BP measurement device
Screening is usually done in a clinic or any health care facility and may identify persons who might have elevated blood pressure. Some persons have what we call a white coat hypertension. Their blood pressure measurements become high when taken in a clinic, by a doctor or clinic staff.
The white coat effect is conceived as a measure of the blood pressure response to a clinic visit, but there is no agreement as to exactly how it should be defined. The effect tends to be greater in older than younger patients, in women than in men, but is present to a greater or lesser degree in almost all hypertensive patients. It is reduced but not removed by drug treatment.
Some studies showed that it is not closely related to overall blood pressure changes and does not predict increase in heart or other cardiovascular complications but other studies show that it may still indicate a blood pressure problem and should be monitored and assessed further.
In ABPM, measurements are taken continuously for 24 to 48 hours, during waking hours and while the person is asleep. In most cases, readings on BP and heart rate are taken every 15 to 30 minutes during the day and every hour at night.
The readings are averaged. Changes in blood pressure, heart rate, blood pressure patterns, and other data are assessed. ABPM provides information on how changes in blood pressure correlate with one’s daily activities and sleep patterns.
This method is strongly recommended by the American Heart Association and American College of Cardiology as the method to confirm the diagnosis of hypertension. It can detect masked hypertension, white coat hypertension, and sustained hypertension. For most people it has been shown that BP decreases by about 10 to 20 percent during sleep. For others, BP might not drop and may even increase.
Measurement using an automated BP device in a clinic closely approximates levels taken by ABPM and home monitoring. In this method, several measurements are automatically obtained by a device and averaged. The person may be alone and unattended or may be accompanied by a doctor, nurse or observer with no talking during the measurements. Some studies, however, have demonstrated lower readings in unattended measurements since these prevent a white coat effect.
Patients being treated for hypertension are advised to monitor their blood pressure at home and at work. Proper positioning, and choice of arm cuff size, rest prior to measurement, and care to empty the bladder, avoid caffeine and cigarette usage are important in getting reliable measurements.
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