A Pharmacist's Guide to OTC Therapy: Blood Pressure Monitors

Many people have become increasingly aware of the consequences and health risks associated with hypertension and are making the decision to invest in a home blood pressure (BP) monitoring device to keep track of BP readings between doctor visits. Three general advantages to monitoring BP outside of a clinician's office are as follows¹:

• To differentiate between an individual's sustained BP versus "whitecoat hypertension"
• To ascertain a patient's response to selected treatment goals
• To improve patient compliance with recommended treatment

Types

There are 3 general categories.¹ Mercury sphygmomanometers typically come with a cuff and an inflation bulb. They work by gravity to give consistent, accurate readings. Although they are easy to use and accurate, their routine use in the home setting is often discouraged because they can be cumbersome. They also present the possibility of a mercury hazard if the glass tubing should break.^1,2 They may not work well for individuals with sight or hearing impairments.

Aneroid monitors are lightweight, portable, and inexpensive. They consist of a numbered dial and a manually inflated cuff. Many are available with a stethoscope attached to the cuff. These monitors require careful patient instruction in listening for Korotkoff sounds. They also require good eyesight and hearing.

Digital monitors can be semiautomatic or automatic, making their operation relatively easy. Features include pulse monitors, automated inflation and deflation of the cuff, memory systems, and digital display of readings. Various devices can measure BP on the wrist, forearm, and fingers. Digital monitors are the most common choice for home-use monitors. Patients should be encouraged to compare the accuracy of their readings with their primary caregiver's equipment when possible.

The Role of the Pharmacist

Because self-management of BP is becoming an important tool in hypertension management, it is crucial for pharmacists to keep abreast of the plethora of home BP monitoring devices available. Pharmacists can be a fundamental source of information:

• By aiding patients in selecting monitors that best suit their needs
• By emphasizing the importance of maintaining a record of BP readings and of discussing the results with their physician
• By educating patients on the factors that may interfere with accurate BP readings
• By encouraging patients to incorporate lifestyle modifications, such as diet and exercise, to aid in BP reduction

Ms. Terrie is a clinical pharmacy writer based in the northern Virginia area.

For a list of references, send a stamped, self-addressed envelope to: References Department, Attn. A. Stahl, Pharmacy Times, 241 Forsgate Drive, Jamesburg, NJ 08831; or send an e-mail request to: astahl@ascendmedia.com.