The idea that continuous ambulatory blood pressure monitoring is preferable to a single measurement in a doctor's office should come as no surprise. A recent study brought this issue into sharp focus (see: Why doctors are excited about mobile blood pressure monitoring). Below is an excerpt from it:
In the first decade of this century, deaths attributed to high blood pressure have increased nearly 40 percent – roughly one in three adults in the US now suffer from the condition....An obvious place to start [to control the disease]: make sure that blood pressure monitoring, and thus diagnosis, is accurate, but a large new study ...is calling into question whether we’re going about it the best way possible...[A recent] review ...found that “ambulatory” monitors worn during a person’s daily routine were as much as 40 percent more accurate predicting heart attacks, strokes, and heart disease than single checks taken at the doc’s....[T]here is quite simply more data being gathered when a cuff worn around one’s arm checks blood pressure at regular intervals throughout a day. But this kind of mobile monitoring also helps catch two types of people who are easily misdiagnosed – those with “white coat” syndrome (see: White coat hypertension), who get nervous in doctor’s offices and experience artificially high blood pressure at precisely the time of monitoring (a condition that may affect as many as 30 percent of people thought to be hypertensive), and those who react oppositely, with lower readings either because they take their meds before going to the doctor’s or because they experience more stress in their home environment....
[Ambulatory monitoring] is going to refine the initial screen performed in a doctor’s office, and give you more accurate results,” said Margaret Piper...,lead author of the review. If Piper’s task force recommendation to switch to ambulatory monitoring becomes final, health insurers would have to pay for it because preventive procedures that are approved by the task force must be covered under the Affordable Care Act....Unfortunately, the ambulatory monitoring recommendation comes at a tricky time – when there are more home monitoring apps than ever, but they appear to be inferior to the ones used in doctor’s offices.....Piper stressed that the ambulatory devices her task force is recommending are not the same – they still involve wearing an arm cuff as opposed to simply pressing one’s finger on a smartphone screen – while the newest ones can now wirelessly connect to smartphones to easily track the readings. They also take readings at regular intervals, as opposed to whenever a user thinks of it.
The good news is that ambulatory blood pressure monitors are more accurate in predicting heart attacks, strokes, and heart disease than single reading taken with a blood pressure cuff in a doctor's office. The latter can be falsely high or falsely low. The bad news is that the various standard blood pressure apps running on smart phones are inaccurate; they are also not designed to take readings at regular intervals. You can buy a blood pressure device with a cuff at a drug store but such a device also suffers from the fact that the recording is not continuous. The solution to this dilemma, as stated above, are inflatable cuff devices worn continuously that transmit wirelessly to cell phones and take readings at predetermined intervals.