Cardiologists know that when patients use a blood pressure cuff at home, they have a significant head start on managing their heart health risk. Now, researchers have learned the added value for African Americans.
According to the American Heart Association, African Americans have the highest rates of disability and death related to high blood pressure of any group in the United States. Researchers at UT Southwestern Medical Center studied data from the Dallas Heart Study and learned that at-home measurements are more accurate, less expensive, and easier to obtain than blood pressure screenings done in medical settings. Patients' readings tend to be higher in the clinic due to stress or anxiety.
"Our study shows that African American men and women who are taking medications to control their hypertension should monitor their blood pressure at home on a regular basis. These home-taken readings are a more accurate measure of how healthy the heart is than clinic readings when compared to other ethnic groups," said Dr. Wanpen Vongpatanasin, Professor of Internal Medicine, at UT Southwestern and Director of the Hypertension Section and its Hypertension Fellowship Program. Checking blood pressure in the clinic alone may miss the opportunity to prevent heart disease, especially in high-risk hypertensive black patients, she added.
The risks are substantial. Having hypertension can potentially lead to heart failure, stroke, kidney failure, and premature death.
The debate among cardiologists has been whether measuring blood pressure in the clinic can lead to under-treatment or over-treatment of hypertension. We wanted to see if measuring blood pressure at home would give us a more accurate picture of heart health."
Dr. Wanpen Vongpatanasin, Professor of Internal Medicine, UT Southwestern
The research team assessed 1,262 black and 927 white participants ages 30-64 years. At-home blood pressure measurements were found to be more likely to predict potentially dangerous thickening of the left heart chamber than blood pressure taken at the doctor's office.
The study, published in the journal Hypertension, is one of the few to examine an at-home approach to blood pressure monitoring in African Americans. It was led by prominent hypertension expert and former UT Southwestern Cardiologist Dr. Ron Victor, who lost his battle with pancreatic cancer in 2018. Dr. Victor was a co-founder of the Dallas Heart Study who became widely known for his heart disease outreach to African American men through community barbershop visits. Both Dr. Vongpatanasin and Dr. Robert W. Haley, Professor of Internal Medicine and Director of the Division of Epidemiology, helped design the Dallas Heart Study in the late 1990s. They considered Dr. Victor to be a mentor and close colleague.
"The Dallas Heart Study is one of the nation's first major population studies designed to focus on the specific heart disease issues of African Americans," Dr. Haley said. "The idea arose from Dr. Victor's concerns over the disproportionate numbers of young black men and women with advanced heart disease that he treated over the years. Although long recognized, he felt the causes and solutions of their disease were not being addressed."
Rader, F. et al. (2019) Superiority of Out-of-Office Blood Pressure for Predicting Hypertensive Heart Disease in Non-Hispanic Black Adults. Hypertension. doi.org/10.1161/HYPERTENSIONAHA.119.13542.