Dr Amit Kaura, Honorary Clinical Lecturer in the National Heart and Lung Institute, discusses the future of blood pressure monitoring in this blog post for ‘Know your Numbers!’ week – a campaign encouraging people to check their blood pressure.
Hypertension, or high blood pressure, is a major global health issue, affecting over 1.3 billion people. Yet, despite its prevalence, many people don’t fully understand what hypertension is, how it impacts health, and how they can manage it effectively.
Hypertension occurs when the force of blood against the walls of your arteries is consistently too high. This force, known as blood pressure, is measured in two numbers: systolic pressure, the pressure in your arteries when your heart beats, and diastolic pressure, the pressure when your heart is resting between beats. A normal blood pressure reading is considered to be around 120/80 mmHg, while readings consistently at 140/90 mmHg or higher indicate high blood pressure.
Often called the ‘silent killer,’ hypertension typically presents no symptoms until significant damage has occurred. Left unchecked, uncontrolled hypertension can lead to serious health issues, including heart disease, stroke, and kidney failure.
My journey into hypertension research is rooted in my background in data analytics in cardiovascular sciences. Hypertension, with its inherently numerical nature, fascinated me from the start. It is not just a static measurement; it is dynamic, with fluctuations that occur throughout the day and in response to various stimuli. This complexity piqued my interest and led me to explore the deeper intricacies of how we define and diagnose hypertension.
The traditional approach of diagnosing hypertension based on a single cut-off value – usually 140/90 mmHg – seemed overly simplistic to me. Through my research, I began to question whether this binary threshold truly captures the nuanced reality of hypertension. There is a wealth of data on the fluctuations and patterns of blood pressure that could offer more insight into cardiovascular risk than a one-time measurement.
My research aims to uncover these patterns, using data analytics to develop a dynamic, individualised approach that could better diagnose and treat hypertension. The aim is to push the boundaries of current diagnostics and potentially redefine what hypertension truly is, going beyond just meeting or exceeding a set threshold.
The Shift to Home-Based Blood Pressure Monitoring
Traditionally, blood pressure has been monitored in clinical settings, but digital health tools are changing this. I am researching how to integrate home-based blood pressure monitors with mobile apps, allowing patients to monitor their health from home and share data with healthcare providers in real time.
Giving patients the tools to track their blood pressure regularly at home means they become more engaged in their treatment, leading to better outcomes. Studies show that people who monitor their blood pressure at home are more likely to stick to their treatment plans and notice any concerning trends early on.[1]
Home monitoring not only empowers patients to take charge of their health but also provides a more complete picture, as blood pressure can vary throughout the day. Relying solely on clinic visits may not provide a complete picture of one’s health.
Blood pressure variability
Another critical aspect of managing hypertension is understanding blood pressure variability – the fluctuations that occur naturally throughout the day. Our research has shown that high variability in blood pressure readings can be a predictor of cardiovascular events, even if average readings fall within a normal range.[2] By tracking these fluctuations at home, both patients and doctors can gain a better understanding of health risks and adjust treatments accordingly.
The findings around blood pressure variability offer new insights into hypertension care. While this concept is still in the research stages, it suggests that shifting from single-point measurements to a more dynamic monitoring approach could lead to personalised treatment strategies, potentially improving patient outcomes. Researchers are exploring whether reducing blood pressure variability can directly lower the risk of cardiovascular events, such as heart attacks and strokes.
However, more evidence is needed before blood pressure variability management becomes a standard part of hypertension guidelines. Future studies will determine whether these approaches should be integrated into clinical practice, with the hope that, one day, they will be included in clinical guidelines for hypertension management. This would represent a significant advancement in the personalized care of patients with hypertension, offering more tailored and effective treatments.
Taking control
Hypertension remains a serious global health issue, but with the right tools and knowledge, it can be effectively managed. The shift towards home-based monitoring, supported by digital tools and apps, represents a new era in hypertension care. By taking control of your health through regular monitoring, lifestyle changes, and close collaboration with your healthcare provider, you can reduce your risk of complications and lead a healthier life. Prevention and early detection are key. Stay informed, stay proactive, and get your blood pressure checked regularly.
- Fletcher BR, Hartmann-Boyce J, Hinton L, McManus RJ. The effect of self-monitoring of blood pressure on medication adherence and lifestyle factors: a systematic review and meta-analysis. Am J Hypertens. 2015;28:1209–21.
- Gupta A, Whiteley WN, Godec T, Rostamian S, Ariti C, Mackay J, Whitehouse A, Janani L, Poulter NR, Sever PS; ASCOT-10 Investigators. Legacy benefits of blood pressure treatment on cardiovascular events are primarily mediated by improved blood pressure variability: the ASCOT trial. Eur Heart J. 2024;45(13):1159-1169.