First large-scale study establishes guidelines for measuring blood pressure at home in U.S. patients

DALLAS – Oct. 29, 2018 – A new study in Hypertension has established that blood pressure is considered to be high at 130/80 or above when measured at home in U.S. patients.

Dr. Wanpen Vongpatanasin, Professor of Internal Medicine and Director of the Hypertension Fellowship Program at UT Southwestern Medical Center, led the team of hypertension and cardiology researchers. Their findings are in agreement with guidelines issued in 2017 by the American College of Cardiology (ACC) and the American Heart Association (AHA).

“Most guidelines have recommended out-of-office monitoring for diagnosis of hypertension, but the normal limits of home blood pressure have not been accurately determined in the U.S. population,” said Dr. Vongpatanasin.

The UT Southwestern team studied data on 3,691 participants, ages 30 to 65, from the Dallas Heart Study and the North Carolina Masked Hypertension Study. Their findings confirmed that 130 over 80 is the level of home blood pressure that best correlates with blood pressure taken at the doctor’s office for white/Caucasian, African-American, and Hispanic/Latino patients.

“This study confirms the value of monitoring blood pressure at home as part of a comprehensive cardiovascular disease prevention strategy,” said Dr. James de Lemos, Professor of Internal Medicine who holds the Sweetheart Ball-Kern Wildenthal, M.D., Ph.D. Distinguished Chair in Cardiology.

According to 2018 data from the AHA, an estimated 103 million U.S. adults have high blood pressure. That’s nearly half of all adults. Cardiologists say at-home screening can better predict hypertension than a single measurement taken by your doctor during an office visit.

The 2017 ACC/AHA hypertension guidelines recommend that a hypertension diagnosis be confirmed with blood pressure measurements taken in the patient’s home. That’s due to a common phenomenon known as “white coat syndrome” when anxiety causes patients’ blood pressure to go up when they are at the doctor’s office, Dr. Vongpatanasin pointed out.

Dr. Wanpen Vongpatanasin

“Home blood pressure readings should be taken after resting quietly for five minutes. They should be taken multiple times, preferably twice a day over five to seven days with a minimum of two readings each time,” she said.

Dr. Vongpatanasin holds the Norman and Audrey Kaplan Chair in Hypertension and the Fredric L. Coe Professorship in Nephrolithiasis Research in Mineral Metabolism.

The Dallas Heart Study was initiated in 2000 with the primary goal of improving the diagnosis, prevention, and treatment of heart disease. It is the only single-center heart study of its size and multiethnic composition. 

Participants included in the analysis live in Dallas and Fort Worth, Texas, and Durham, North Carolina. The study was limited to young and middle-aged adults under age 65. The majority of the subjects were overweight or obese, and results may not be applicable to normal weight or lean patients.

Other UT Southwestern researchers who contributed to this work include Dr. Sandeep R. Das, Associate Professor of Internal Medicine; Dr. Jarett D. Berry, Associate Professor of Internal Medicine and a Dedman Family Scholar in Clinical Care; Dr. Amit Khera, Professor of Internal Medicine, Director of UT Southwestern’s Preventive Cardiology Program, and holder of the Dallas Heart Ball Chair in Hypertension and Heart Disease; Colby Ayers, Clinical Sciences faculty associate; and Dr. Hamza Lodhi, a Hypertension fellow.

UT Southwestern is celebrating its 75th anniversary during 2018.

About UT Southwestern Medical Center

UT Southwestern, one of the premier academic medical centers in the nation, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty has received six Nobel Prizes, and includes 22 members of the National Academy of Sciences, 16 members of the National Academy of Medicine, and 15 Howard Hughes Medical Institute Investigators. The faculty of more than 2,700 is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide care in about 80 specialties to more than 105,000 hospitalized patients, nearly 370,000 emergency room cases, and oversee approximately 2.4 million outpatient visits a year.