I just heard that people with high blood pressure are supposed to go out and buy machines to monitor their pressure at home. Is this really a good idea or just a scam to get people to buy the monitors?
Several medical organizations, including the American Heart Association, have recommended that everyone who has high blood pressure invest in a home monitor to perform regular checks. This was proposed because only one-third of the 72 million Americans who have high blood pressure have it under control. Frequent monitoring - by patients, at home - gives doctors a more realistic idea of the range of a patient's blood pressure and shows more clearly how pressure is responding to medication. More frequent monitoring than is possible with visits to doctors' offices also facilitates fine tuning of drug dosages, as well as revealing the effects of such lifestyle measures as weight loss, exercise, and limiting salt intake.
There is precedent for this type of home testing: for years, people with diabetes have been monitoring their blood sugar with home devices. Blood pressure monitors for home use cost from $50 to $100. You can get them at drug stores and online. The groups that recommend them have also called upon insurers to pay for monitors prescribed by physicians. If you buy one on the advice of your physician, you'll have to bring it into the office so its measurements can be compared to those obtained there.
Your suspicion that this recommendation may have been influenced by manufacturers of the home monitors has been voiced elsewhere. Experts who think home monitoring is a great idea have said that the recommendation would be more compelling if one of the leading manufacturers of the monitors didn't support the American Heart Association's blood pressure Web site to the tune of $300,000 to $400,000 per year. (However, that amount is only a small fraction of the AHA's $800 million annual revenues.)
Instead of focusing on the unfortunate issue of industry ties, I would look at the individual benefits home monitoring can make possible. These include a clearer idea of your blood pressure, better medical management, and, perhaps, motivation to make the lifestyle changes that can help: losing weight, increasing exercise, practicing relaxation methods, and reducing salt intake.
Andrew Weil, M.D.
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译文:
观测你的血压
我听说人们期望那些血压高的人去买台仪器在家里测量自己的血压。这真正是个好主意，还是仅仅为了诱骗人们去购买仪器？
包括美国心脏协会在内的一些医疗机构建议每一位高血压患者都买一台家用血压计来做定期的检查。他们这样建议是因为在美国七千二百万高血压患者中只有三分之一的人能把血压控制住。患者们在家里经常自测血压能给医生们提供关于患者血压波动范围更为实际的概念，也能清楚地表明患者血压对药物的反应。尽可能多的监测血压加上去看医生有助于对药物剂量的精确调整，同时也能揭示像减重、锻炼、限制摄盐量等这些生活调理的效果。
这种家庭方式的测量是有先例的，多年以来，糖尿病患者们一直用家庭仪器观测自己的血糖。家用血压计需要花费50-100美元，你可以在药店或网上购买。建议购买家用血压计的机构也号召保险公司为医生开处方的血压计投保。如果你在你的医生的建议下购买一台家用血压计，你得把它带到医生那里以便使它的测量结果跟医生那里的仪器所测量的结果相对照。
购买家用血压计的建议可能是受到了仪器制造商的影响，对此表示怀疑的呼声遍地。认为家用血压计是个好主意的专家们表明，如果这些大的仪器制造商们其中有一家每年不出支多达30-40万美元来支持美国心脏协会旗下的血压网站的话，购买家用血压计的这种推荐就会更加强制。（然而，相对于AHA每年8亿美元的收益来说这个数字只是其中的一小部分）
不去关注产业链中令人遗憾的问题，我将着眼于家用血压计能实现的个体利益。其中包括对你自己血压的更清晰的概念，更合理的药物治疗，可能还包括，促动有效的生活方式的改变，如减重、加强锻炼、采用放松法、减少摄盐量。
医学博士：安德鲁
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