“As high blood pressure disproportionately affects Black, Hispanic and Indigenous populations in the U.S., the American Heart Association continues its commitment to improve health equity nationwide, we strive to ensure that everyone has access to resources for a healthier life,” said AHA volunteer president Michelle A. Albert, M.D., M.P.H., FAHA, the Walter A. Haas-Lucie Stern endowed chair in cardiology, professor of medicine and admissions dean at University of California San Francisco School of Medicine. “We appreciate the support from Elevance Health Foundation, which enables us to work in the communities where the need is greatest.”

Acccording to an AHA news release, a recent poll by the Association was designed to evaluate patient perceptions and barriers to blood pressure management in the home setting. The survey participants—patients with high blood pressure at clinics in under-resourced areas throughout the U.S.—were provided with blood pressure kits to monitor their blood pressure at home as part of the Building Healthier, Safer Communities Together initiative supported by Elevance .More than three quarters (88%) of the participants said that they planned to check their blood pressure levels at least once daily, and over half of the respondents (64%) said they believe that monitoring their blood pressure at home will help to improve their overall health.

The program is a community-based initiative focused on blood pressure control in medically under-resourced communities and is one component of a nationwide project with Federally Qualified Health Centers (FQHCs) and other community clinics to facilitate and provide health education, guidance and resources to patients.

“Nearly half of all Americans have high blood pressure, which is why implementing interventions that target health measures – such as increased awareness and management of blood pressure – are crucial to not only improving the health of people living in historically under-resourced communities, but advancing equity for all,” said Shantanu Agrawal, M.D., chief health officer at Elevance Health. “Through this initiative, more than 3,500 patient care kits are in the hands of people at the highest risk, allowing them to monitor their blood pressure at home.”

According to research, community health workers can make a difference in improving patients’ access to care and treatment for health concerns such as high blood pressure. Community health workers can aid their patients and communities in various roles beyond just patient medical care, including providing health education, linking people with social services, and improving overall patient-health professional communication.

Communication is important, according to many of the survey responses. When patients were asked what could help them monitor their blood pressure at home, 38% replied that regular in-person consultations with a doctor or a nurse would be helpful, and 26% responded that more opportunities for education on blood pressure and hypertension would be helpful.

Adult patients from 11 clinics in nine markets throughout the U.S. who were diagnosed with high blood pressure and received a self-monitoring blood pressure kit were invited to participate in the survey. The survey was planned to identify gaps in knowledge of patients encouraged to regularly monitor their blood pressure at home, and is part of the Building Healthier, Safer Communities Together (BHSCT) program. Through the BHSCT initiative, the American Heart Association provided primary healthcare professionals with 350 patient care kits in 16 under-resourced target communities, Baton Rouge, La., New Orleans, La., Houston, Atlanta, Ga., Des Moines, Nashville, Tenn., Newport, Tenn., Los Angeles, Calif., Seattle, Wash., St. Louis, Mo., New York, N.Y., Indianapolis, Ind., Miami, Fla. and Cincinnati, Ohio, to distribute to their high-risk patients in support of remote blood pressure monitoring. The purpose of this evaluation is to use survey-based data collection to assess participant characteristics, perceptions and barriers to blood pressure management. This evaluation will inform the program for the next two years.

The program is a community-based initiative focused on blood pressure control in medically under-resourced communities and is supported by Elevance. Surveys were provided in both English and Spanish, and participants had the option to complete the 18-question survey in electronic form on a tablet during a clinic visit, or in a paper format. Data was collected between August 2021 and June 2022 and analyzed by the Evaluation Team in the Qualtrics system on behalf of the AHA. A total of 317 participants attempted the survey, 80% of whom were age 45 and older. Most of the responses received were from the electronic version of the survey (64%).[7] The majority of respondents identified as female (55%), aged 45-64 (59%), and as being of Hispanic, Latino, or Spanish origin (58%).

High blood pressure, according to the AHA’s 2017 Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure, is defined as a consistent blood pressure measurement of 130 over 80 or higher. The guidelines also state that some OTC pain relievers may elevate blood pressure. 

While the majority of adults in the general population, as well as people with high blood pressure, aren’t sure about the effect of OTC pain medicine on their blood pressure, only a little more than half of those diagnosed with high blood pressure, who take OTC pain relievers (53%) check with their doctor before taking this medicine.

“People who have high blood pressure or are being treated with blood pressure medication – along with their loved ones and caretakers – need to be informed about safe over-the-counter pain relievers,” said Willie Lawrence, Jr., M.D., interventional cardiologist, medical director for health equity, Spectrum Health in Benton Harbor, Michigan, and volunteer lead of the AHA’s National Hypertension Control Initiative oversight committee.

“Because some pain relievers may cause elevated blood pressure, the [AHA] recommends consulting your doctor or pharmacist and making sure you read the label before taking any over-the-counter medication for pain, especially if you’ve been diagnosed with high blood pressure.”

Conducted by The Harris Poll, the survey polled 2,013 U.S. adults aged 18 and older. Additional findings from the survey include:

38% of those with high blood pressure think over-the-counter pain relievers may raise blood pressure.

Only 21% of U.S. adults know that acetaminophen does not raise blood pressure, and those with high blood pressure are only slightly more aware of this fact (28%).

39% of U.S. adults with high blood pressure report acetaminophen is the over-the-counter medication they take most often for pain.

Only 10% of U.S. adults with HBP self-measure their BP multiple times a day and only 14% do so at least once a day.

In the U.S., high blood pressure is the No. 1 preventable cause of heart disease and stroke and is second only to cigarette smoking as a preventable cause of death for any reason. Checking your blood pressure regularly at home with a validated blood pressure device for the most accurate reading, and working with your doctor on a plan to control it, is a proven way to manage your blood pressure.

According to the American Heart Association, about 1 of every 2 of U.S. adults has high blood pressure, or hypertension. More than one in three adults with high blood pressure might not know they have it. High blood pressure is defined as having a systolic pressure (the top number in a reading) of 130 mm Hg or higher, or a diastolic pressure (the bottom number) of 80 mm Hg or higher.

“Most hypertension is diagnosed  and treated based on blood pressure measurements taken in a doctor’s office, even though the U.S. Preventive Services Task Force and the American Heart Association recommend that blood pressure measurements be taken outside of the clinical setting to confirm the diagnosis before starting treatment,” said lead study author Beverly Green, M.D., M.P.H., senior investigator and family physician at Kaiser Permanente Washington Health Research Institute and Kaiser Permanente Washington in Seattle. “It is the standard that blood pressure monitoring should be done either using home blood pressure monitoring or 24-hour ambulatory blood pressure monitoring prior to diagnosing hypertension.”

Twenty-four-hour ambulatory blood pressure monitoring devices, worn day and night to take continuous blood pressure readings, are generally considered the “gold standard” for out-of-office measurement to determine a diagnosis of high blood pressure. However, blood pressure measured on a home device, with a traditional blood pressure arm cuff, can be a more practical and convenient approach.

Green and colleagues studied adherence and acceptability of different blood pressure measuring methods among 510 adults who had elevated blood pressure yet had not been diagnosed with high blood pressure. They were participants in the Blood Pressure Checks for Diagnosing Hypertension (BP-CHECK) trial. Participants in the study were an average age of 59 years old; 75% were non-Hispanic white, 7% African American, 6% Asian, 5% Hispanic white and 7% other; half were male; and the average blood pressure was 150/88 mm Hg. None of the participants were taking blood pressure-lowering medications.

Participants were randomly assigned to one of three groups for determining a new diagnosis of hypertension: clinic measurements, home monitoring or kiosk blood pressure monitoring.

Those in the group for clinic measurements were asked to return to the clinic for at least one additional blood  pressure check, as is routine in diagnosing hypertension in clinical practice. The home group received home blood pressure machines, were trained to use them and were asked to take their blood pressure twice a day with two measurements each time, for five days, for a total of 20 measurements. The kiosk group was asked to take their blood pressure at a kiosk in their clinic or at a nearby pharmacy on three separate days, with three measurements each time, for a total of nine measurements. All participants were asked to complete their group-assigned diagnostic regimens within 3 weeks, and then to complete 24-hour ambulatory blood pressure monitoring. Researchers compared adherence to and the acceptability among each diagnostic method.

They measured adherence to monitoring by noting the percent of individuals in each group who completed their assigned measurement method as instructed. They measured acceptability with questionnaires.

Researchers found:

Overall acceptability was highest for the at-home group, followed by the clinic and kiosk groups. 24-hour ambulatory blood pressure monitoring was the least acceptable option.

Participants were least likely to adhere to the monitoring regimen in the kiosk group. Adherence was more than 90% among those in the home testing group; more than 87% in the clinic group; nearly 68% in the kiosk group; and 91% for 24-hour ambulatory monitoring among all participants.

“Home blood pressure monitoring was the most preferred option because it was convenient, easy to do, did not disturb their daily personal or work routine as much, and was perceived as accurate,” Green said. “Participants reported that ambulatory blood pressure monitoring disturbed daily and work activities, disrupted sleep and was uncomfortable.”

When asked which diagnostic testing regimen they would prefer, more than half chose home blood pressure monitoring, especially if they were assigned to the home group, where almost 80% preferred home monitoring.

Green suggests that health care professionals routinely offer home blood pressure monitoring to their patients with elevated blood pressure. This might involve providing home blood pressure monitors, training patients and collecting and averaging several days of blood pressure readings.

The American Heart Association is striving to improve blood pressure control rates in historically under-resourced communities across the country by providing training, technical assistance and resources to community health centers for proper blood pressure measurement and management. In addition, collaborations with community-based organizations provide blood pressure education, monitoring and management information and resources to their neighbors. The Association is also marketing directly to communities to raise awareness about the importance of self-blood pressure monitoring, and working with a health care professional on a plan for blood pressure control.

“Health care professionals should work toward relying less on in-clinic visits to diagnose hypertension and supporting their patients in taking their blood pressure measurements at home,” Green said. “Home blood pressure monitoring is empowering and improves our ability to identify and treat hypertension, and to prevent strokes, heart attacks, heart failure and cardiovascular death.”

A study limitation is that participants were mainly white, which is not representative of all people who have high blood pressure. According to American Heart Association statistics, about 50% of white and Hispanic men and 40% of white and Hispanic women have high blood pressure, while 58% of Black men and women have it.

High blood pressure, or hypertension, is a risk factor for cognitive decline and dementia in older adults. Nearly half of American adults have elevated blood pressure. Treating high blood pressure with blood pressure-lowering medicines reduced the cases of mild cognitive impairment by 19% in one large trial (SPRINT MIND).

ACE inhibitors, angiotensin II receptor blockers (ARBs), calcium channel blockers and diuretics are different classes of blood pressure-lowering medicines. Each class acts in a different way to reduce blood pressure, and some cross the blood-brain barrier, thereby impacting cognitive function.

“Research has been mixed on which medicines have the most benefit to cognition,” said study author Daniel A. Nation, Ph.D., ​an associate professor of psychological science in the Institute for Memory Impairments and Neurological Disorders at the University of California, Irvine. ”Studies of angiotensin II receptor blockers and angiotensin-converting-enzyme (ACE) inhibitors have suggested these medicines may confer the greatest benefit to long-term cognition, while other studies have shown the benefits of calcium channel blockers and diuretics on reducing dementia risk.”

This is the first meta-analysis to compare the potential impact over time of blood pressure lowering medicines that do vs. those that do not cross the blood-brain barrier. The medicines were evaluated for their effects on several cognitive domains, including attention, language, verbal memory, learning and recall.

“Hypertension occurs decades prior to the onset of dementia symptoms, affecting blood flow not only in the body but also to the brain,” Nation said . “Treating hypertension is likely to have long-term beneficial effects on brain health and cognitive function later.”

Researchers gathered information from 14 studies of nearly 12,900 adults ages 50 years and older. These included studies done in the United States, Australia, Canada, Germany, Ireland and Japan. The meta-analysis found:

Older adults taking blood pressure-lowering medicines that cross the blood-brain barrier had better memory recall for up to 3 years of follow-up compared to those taking medicines that do not cross the blood-brain barrier even though the former group had a higher level of vascular risk.

Adults taking hypertension medications that did not cross the blood-brain barrier had better attention for up to 3 years of follow-up.

“These findings represent the most powerful evidence to-date linking brain-penetrant ACE-inhibitors and angiotensin receptor blockers to better memory. It suggests that people who are being treated for hypertension may be protected from cognitive decline if they medications that cross the blood-brain barrier,” said study co-author Jean K. Ho, Ph.D., a postdoctoral fellow at the University of California, Irvine.

Blood pressure is considered elevated at 120/80 mm Hg and higher. The current American Heart Association/American College of Cardiology guidelines for treating high blood pressure suggest changes to diet and activity levels to lower blood pressure and adding blood pressure-lowering medication for people with levels of 130/80 mm Hg or higher depending on their risk status. If blood pressure reaches 140/90 mm Hg, blood pressure-lowering medication is recommended.

Limitations of this analysis are that the authors could not account for differences in racial/ethnic background based on the available studies, and there is a higher proportion of men vs. women in the group who took medications that cross the blood-brain barrier. This is an important area of future research since previous studies have shown that people from various racial/ethnic backgrounds may respond differently to different blood pressure medications.

“Ultimately, what we noted in this study is a continued discussion of ‘it’s not just how much fat you have, but where the fat is located,’” said principal investigator Aayush Visaria, M.P.H., a fourth-year medical student at Rutgers New Jersey Medical School in Newark, New Jersey, said in a news release from the AHA. “Although we know confidently that fat around your waist is detrimental to health, the same cannot be said for leg fat. If you have fat around your legs, it is more than likely not a bad thing and may even be protecting you from hypertension, according to our findings.”

The investigators examined the rate of three types of high blood pressure in relation to the percentage of fat tissue in the legs of nearly 6,000 adults enrolled in the 2011-2016 National Health & Nutrition Examination Surveys. Average age of the participants was 37, nearly half were female and 24% had high blood pressure, defined as blood pressure >130/80 mm Hg.

Special X-ray scans measured fat tissue in the legs, and these measures were compared to overall body fat tissue. Investigators classified participants as having either a high or low percentage of leg fat, with high fat defined as 34% or more for males, and 39% or more for females.

Participants with higher percentages of leg fat were less likely than those with lower levels of fat to have all types of high blood pressure.

Compared to those with lower percentages of leg fat, participants with higher percentages of leg fat were 61% less likely to have the type of high blood pressure where both numbers are elevated.

In addition, risk for participants with higher leg fat was 53% lower for diastolic high blood pressure (the second number in a blood pressure reading, measuring pressure between heart beats) and 39% lower for systolic high blood pressure (the first number in a reading, measuring pressure when the heart beats).

After adjusting for various factors, such as age, sex, race and ethnicity, education, smoking, alcohol use, cholesterol levels and waist fat, the risk for high blood pressure was still lower among participants with higher percentages of leg fat, although not as low as before adjusting for these factors.

“If these results are confirmed by larger, more robust studies, and in studies using easily accessible measurement methods like thigh circumference, there is the potential to affect patient care,” Visaria said. “Just as waist circumference is used to estimate abdominal fat, thigh circumference may be a useful tool, although it’s a bit cumbersome and not as widely studied in the U.S. population.”

Several limitations could have affected the study’s results. First, the study could not determine cause and effect, since information on blood pressure and percentage of fat tissue in the legs were measured at the same time. Second, a larger group of participants is needed to yield more information about the effects on high blood pressure of varying degrees of fat tissue in the legs. Finally, all study participants were under the age of 60, so the results may not apply to older adults, who are generally at greater risk for high blood pressure.

For more on heart health, click here to visit the American Heart Association’s website.

That’s why the American Heart Association, the leading voluntary health organization devoted to a world of longer, healthier lives is observing providing information and tools to help Americans reduce and control their blood pressure.

“Now, more than ever, it is important for you to pay attention to your blood pressure, know your numbers, work with your healthcare provider to control your levels and manage your risks. Lowering your blood pressure is one of the most important things you can do to reduce your risk of having a heart attack or stroke,” said Mitchell S. V. Elkind, M.D., M.S., FAHA, FAAN, president of the American Heart Association and professor of neurology and epidemiology at Columbia University in New York City.

Manage your blood pressure, control it, and live longer. Small changes can make a big difference in managing your blood pressure:

Check your blood pressure regularly. 120/80 or below is considered normal. If your blood pressure is 130/80 or above, that is high blood pressure and means an increased risk for heart disease and stroke.

Take blood pressure medication as prescribed. Prescription medication can be one of the most effective ways to manage your blood pressure. If you have concerns, let your doctor know. They may be able to adjust your prescriptions and get you back on track.

Read the labels on over-the-counter medicines. Over-the-counter medicine can be as important as your prescription medicine to managing your blood pressure. Make sure to read the labels when shopping for over-the-counter medications. Pain relievers such as ibuprofen and naproxen can raise blood pressure. The American Heart Association recommends considering acetaminophen for pain as an alternative. Talk to your doctor about pain relievers that are right for you.

Maintain a healthy weight. Strive for a body mass index (BMI) between 18.5 and 24.9. To check your numbers, click here.

Eat healthfully. Eat lots of fruit, vegetables and whole grains. Select low-fat dairy products, lean meats, and reduce saturated and total fat.

Reduce sodium/salt. Ideally, stay under 1,500 mg a day, but aim for at least a 1,000 mg per day reduction from your current consumption.

Be active. Aim for at least 150 minutes of activity per week, with a combination of moderate and vigorous aerobic activity.

Limit alcohol. Drink no more than one to two drinks a day. (One for most women, two for most men.) If you don’t drink, don’t start.

No smoking! Both tobacco products and vaping have nicotine that can raise your blood pressure. If you don’t smoke, don’t start.

For more information from the American Heart Association, click here.

“We knew that high blood pressure medication was protective in general among older people; however, we focused on whether it is also protective in frail patients with many other medical conditions who are usually excluded from randomized trials,” said Giuseppe Mancia, M.D., lead study author and professor emeritus at the University of Milano-Bicocca in Milan, Italy.

Researchers reviewed data on almost 1.3 million people aged 65 and older (average age 76) in the Lombardy region of northern Italy who had three or more high blood pressure medication prescriptions in 2011-2012. Examining the public health care database, researchers calculated the percentage of time over the next seven years (or until death) that each person continued to receive the medications.

To look separately at outcomes among older people with various medical conditions, researchers used a previously developed score that accounts for 34 different health factors and has a close relationship with mortality.

Researchers compared roughly 255,000 people who died during the seven-year follow-up with age-, gender-, and health-status-matched controls who survived and divided them into four groups of health status: good, medium, poor or very poor.

The probability of death over seven years was 16% for people rated in good health at the beginning of the study. Mortality probability increased progressively to 64% for those rated in very poor health.

Compared with people with very low adherence to blood pressure medications (dispensed pills covered less than 25% of the time period), people with high adherence to blood pressure medications (more than 75% of the time period covered) were 44% less likely to die if they started in good health; and 33% less likely to die if they started in very poor health.

A similar pattern was seen with cardiovascular deaths. The greatest survival benefit was among the people who started in good health, and the most modest survival benefit was in those who started in very poor health.

“Our findings definitely suggest that even in very frail people, antihypertensive treatment reduces the risk of death; however, the benefits may be smaller in this group,” Mancia said.

No matter what a person’s initial health status, survival benefits were greatest in those who received blood pressure medication to cover more than 75% of the follow-up period, compared with those with intermediate (25-75%) or low levels (less than 25%) of coverage, highlighting the importance of consistent use of blood pressure medications.

“Do your best to encourage and support patients to take their medications, because adherence is crucial to getting the benefits. Medications do nothing if people don’t take them,” Mancia said.

Prescription medications given to elderly people living in nursing homes or assisted-living homes in Italy are not included in the national database, so the study’s results may only apply to elderly people living in the community. In addition, all data for this analysis are from Italy, where hospitalizations and blood pressure medications are available for free or at low cost; thus, the study’s findings may not be generalizable to countries with a different health care system.

Supine hypertension is present in about half of people with autonomic failure, a chronic degenerative disease that affects the part of the nervous system that regulates involuntary functions such as blood pressure and heart rate. Overnight increases in blood pressure are associated with damage to the heart and kidneys. It can also increase urine production, which can worsen a condition where a person’s blood pressure rapidly drops upon standing, such as when first getting out of bed in the morning.

Researchers studied 10 patients with autonomic failure and supine hypertension. The average age of the study participants was 76 years, with a systolic (upper number) blood pressure of 168 mm Hg measured in the lying position. During the two-night study, participants received heat at 100 degrees Fahrenheit from a medical grade heating pad placed under their torso on one night, and an unheated pad on the other. Supine blood pressure was monitored every two hours from 8 p.m. to 8 a.m., and heat therapy was applied from 10 p.m. to 6 a.m.

The researchers found that heat therapy applied during sleep decreased systolic blood pressure, with a maximum reduction of 30 mm Hg after four hours of heat. Despite lowering overnight systolic blood pressure, heat therapy did not decrease nighttime urine production or improve the sudden drop in morning blood pressure.

The use of local, controlled heat therapy may be a novel and simple approach to treatment.

“In many patients with autonomic failure, heat exposure decreases blood pressure by shifting blood to skin vessels,” said Luis E. Okamoto, M.D., study author and research assistant professor of medicine at Vanderbilt University Medical Center in Nashville, Tennessee. “The use of local, controlled heat therapy may be a novel and simple approach to treat supine hypertension in these patients without using medications; however, additional studies are needed to assess the long-term safety and efficacy of this approach.”

Among the study’s limitations are its small size and its focus on primary forms of autonomic failure, which is a rare condition. Although the study population was Caucasian, the researchers anticipate that the results may be applicable to other ethnic groups.

The link between poor sleep and cardiovascular health problems is increasingly being documented, but the reason for the relationship is less understoodl

The study, led by the University of Arizona, will be published in the journal Psychosomatic Medicine. It offers one possible explanation for why sleep problems have been shown to increase the risk of heart attack, stroke and even death from cardiovascular disease.

Researchers set out to learn more about the connection in a study of 300 men and women, ages 21 to 70, with no history of heart problems. Participants wore portable blood pressure cuffs for two consecutive days. The cuffs randomly took participants’ blood pressure during 45-minute intervals throughout each day and also overnight.

At night, participants wore actigraphy monitors – wristwatch-like devices that measure movement – to help determine their “sleep efficiency,” or the amount of time in bed spent sleeping soundly.

Overall, those who had lower sleep efficiency showed an increase in blood pressure during that restless night. They also had higher systolic blood pressure – the top number in a patient’s blood pressure reading – the next day.

More research is needed to understand why poor sleep raises blood pressure and what it could mean long-term for people with chronic sleep issues. Yet, these latest findings may be an important piece of the puzzle when it comes to understanding the pathway through which sleep impacts overall cardiovascular health.

“Something is going on with sleep and our heart health.”

“Blood pressure is one of the best predictors of cardiovascular health,” said lead study author Caroline Doyle, a graduate student in the UA Department of Psychology. “There is a lot of literature out there that shows sleep has some kind of impact on mortality and on cardiovascular disease, which is the No. 1 killer of people in the country. We wanted to see if we could try to get a piece of that story – how sleep might be impacting disease through blood pressure.”

The study reinforces just how important a good night’s sleep can be. It’s not just the amount of time you spend in bed, but the quality of sleep you’re getting, said study co-author John Ruiz, UA associate professor of psychology.

Improving sleep quality can start with making simple changes, Ruiz said.

“Keep the phone in a different room,” he suggested. “If your bedroom window faces the east, pull the shades. For anything that’s going to cause you to waken, think ahead about what you can do to mitigate those effects.”

For those with chronic sleep troubles, Doyle advocates cognitive behavioral therapy for insomnia, or CBTI, which focuses on making behavioral changes to improve sleep health. CBTI is slowly gaining traction in the medical field and is recommended by both the American College of Physicians and the American Academy of Sleep Medicine as the first line of treatment for insomnia.

Doyle and Ruiz say they hope their findings – showing the impact that even one fitful night’s rest can have on the body – will help illuminate just how critical sleep is for heart health.

“This study stands on the shoulders of a broad literature looking at sleep and cardiovascular health,” Doyle said. “This is one more study that shows something is going on with sleep and our heart health. Sleep is important, so whatever you can do to improve your sleep, it’s worth prioritizing.”

Investigators say that approximately 20 to 30 percent of adults in the United States may have what’s known as “masked hypertension.” With masked hypertension, patients have lower blood pressure readings in the doctor’s office than they do outside it.

Statistics on this phenomenon have been published only over the past 15 to 20 years, according to Paul Muntner, Ph.D., lead author of the latest scientific statement on blood pressure measurement from the American Heart Association.

The statement was published in Hypertension, a journal of the American Heart Association.

“A key message from the new scientific statement is the importance of measuring blood pressure outside of the doctor’s office,” said Muntner, an epidemiologist at the University of Alabama at Birmingham School of Public Health. “Masked hypertension is associated with a high risk for heart disease and stroke. Therefore, it is important that people get their blood pressure measured correctly so they can have hypertension diagnosed and they can get started on blood pressure lowering medications.”

The statement outlines ways to accurately measure blood pressure outside of the doctor’s office in order to help the physician diagnose hypertension.

“Masked hypertension may be diagnosed through ambulatory blood pressure monitoring, which is when the patient wears a blood pressure cuff for 24 hours and has their blood pressure measured throughout the day and while they are asleep,” Muntner said. “In addition to getting a lot of measurements, this approach allows one’s blood pressure to be measured in their natural environments.”

The 2017 American College of Cardiology/American Heart Association Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure lowered the blood pressure levels used to define hypertension from 140/90 mm Hg to 130/80 Hg. It also included recommendations on how to properly take blood pressure measurements, both in and out of the doctor’s office.

Home blood pressure monitoring is recommended for people on anti-hypertensive medication.

The scientific statement from Muntner and his colleagues supports recommendations from the guideline, including using electronic devices, known as oscillometric devices, in clinical settings.

“It is now recognized that these devices are accurate and reduce the risk of human error,” Muntner said. “These are new devices that are automated and measure blood pressure multiple times in a row with a single push of a button. The AHA guideline recommends that blood pressure be taken two or more times at the doctor’s visit, but we know that is rarely done. The automated devices make it easier to do that.”

The scientific statement supports the recommendations on the best way to take your blood pressure, both at the doctor’s office and at home.

For accurate blood pressure readings, you should sit up straight in a chair with a supported back, feet flat on the floor, rest your arm on a solid surface, and not talk to anyone or look at your phone for three to five minutes before the reading is taken. You should also not smoke, drink caffeine or exercise at least 30 minutes before your blood pressure is taken.

People who measure their blood pressure at home should follow the same recommendations.

“Home blood pressure monitoring is very important and is widely recommended for people with hypertension, especially for people who are on anti-hypertensive medication,” Muntner said. “The scientific statement suggests people with hypertension measure their blood pressure two times in the morning and two times in the evening for seven days before each doctor’s visit.”

The American Heart Association continues to recommend that patients measure their blood pressure at home using a blood pressure device with an upper arm cuff that has been checked for accuracy by a health care provider.v