BODY : HOME BLOOD-PRESSURE CHECKS GAIN MOMENTUM.

Byline: Linda Carroll Medical Tribune News Service

Most people can learn to perform blood-pressure measurements in their homes, a practice that may yield more accurate readings than those done in a doctor's office, a new French study finds.

When researchers at the Broussais Hospital in Paris asked 1,710 patients with hypertension to try monitoring their blood pressure at home, they found that almost two-thirds were able to use the blood-pressure cuff correctly and to provide their doctors with regular measurements.

An American heart specialist said he was encouraged by the study's results.

``I think it's great,'' said Dr. Joseph Alpert, a cardiologist and head of the department of medicine at the University of Arizona College of Medicine in Tucson. ``I've had my patients doing it for years.''

Blood-pressure readings recorded in the home also were substantially lower than those obtained in the doctor's office, said lead author Dr. Gilles Chatellier, a researcher at the Clinical Investigation Center at the Broussais Hospital.

On average, systolic blood pressure - the upper number - dropped 13 millimeters per mercury of blood, while diastolic readings - the lower number - fell 8 millimeters per mercury of blood, according to the study, which appears in the July issue of the American Journal of Hypertension.

The average blood-pressure reading was 166/101 when recorded in the doctor's office, vs. 153/93 when study participants performed what the researchers called self-measurement of blood pressure (SMBP).

The lower blood-pressure values in the home appear to confirm physician suspicions that an office-visit can wreak havoc with a patient's blood pressure. ``I've believed for a while in the idea of `white-coat' hypertension,'' Alpert said.

White-coat hypertension is a term doctors use to describe the blood-pressure-raising effects of simply coming into a doctor's office or clinic. Many patients get so nervous about being in a medical setting that their blood pressure skyrockets.

``These are threatening environments,'' Alpert explained. ``And some people are more threatened than others. Let's face it - no one comes in to the clinic for a vacation.''

Other studies have found that home monitoring gives doctors a better idea of how well blood-pressure-lowering drugs are working, Chatellier noted.

And getting an accurate reading can be particularly important when it comes to figuring out a treatment plan for hypertensive patients, Alpert said.

Patients with borderline hypertension in the office may have home readings that are sufficiently low that they don't need any treatment at all, he explained.

Beyond this, home readings may help doctors figure out a follow-up plan for patients who don't appear to be doing better with medication, Alpert said. Since some patients may have white-coat hypertension, office readings may obscure the beneficial effects of therapy, he said.

Before adding new medications, doctors should have their patients try monitoring themselves at home, Alpert said. ``These medications have lots of side effects,'' he said. ``And sometimes what you see at home is remarkably lower.''