Fifteen years ago, blood pressure monitors were considered hands-off for patients. Now physicians prescribe home monitoring for their patients with high blood pressure. Keeping tabs on pressure can motivate patients to take medicine, encourage them to watch their diet and reduce the frequency of doctor's office visits.
Choosing a blood pressure monitor, however, is no easy task. At least 12 companies now manufacture four different types of home monitors that vary widely in cost.
To sort out the confusion, researchers Gary R. Schmidt and Joan Hoettels Wenig rate monitors for accuracy, ease of use, durability and costs in an evaluation just released by the American Pharmaceutical Assn. Here's what shoppers need to know before heading to the corner pharmacy:
\o7 Mercury \f7 monitors, priced at $40-$75, are the most accurate and durable.
\o7 Aneroid \f7 monitors, priced at $15 to $40, aren't as accurate, but, according to study co-author Schmidt, they are reliable enough for most patients. Users listen for the sounds of blood flow and read measurements on a calibrated dial.
But an \o7 electronic \f7 monitor, which converts the blood flow sounds electronically to a reading, are more convenient for patients with hearing loss, vision problems or coordination difficulties. Priced at $70 to $400, the fragile monitors are, however, more costly.
\o7 Finger \f7 monitors, in which a cuff is placed over the index or middle finger, are lowest on the reviewers' list. They cost $100 to $150.
Despite the affordability of monitors, everyone doesn't need to jump on the bandwagon. "I would only recommend home monitoring for hypertensive or borderline hypertensive patients," says Schmidt, a hypertension research coordinator at the William S. Middleton Veterans Administration Hospital in Madison, Wisc. "And then, only with proper instruction from a doctor or nurse."
To make sure home measurements are accurate, Dr. Wayne Flicker, a physician at Cigna Healthplans of California, asks patients to bring their monitors to his office periodically. Flicker puts his office blood pressure monitor on one arm; the patient puts the home monitor on the other. If the readings jibe, Flicker is satisfied.
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Even the most safety-conscious parents think laundry detergent poses little poisoning risk. But today's nonphosphate detergents are so alkaline that even small amounts can damage children's gastrointestinal tract and cause severe respiratory problems, say doctors from the Children's Hospital National Medical Center in Washington.
