We’ve been thinking a lot about blood pressure recently. Hypertension, unfortunately, has been in the news: it is known to increase the risk of severe complications from the new coronavirus, COVID-19. That makes it a better time than ever to concentrate on our metabolic health. And with routine doctor’s visits now temporarily suspended across most of the globe, perhaps it’s also a better time than ever to take some health monitoring tasks into our own hands.
As it happens, at-home blood pressure monitoring is already strongly recommended by many experts, including the European Society of Cardiology and the American Heart Association. More than a few studies have shown that people measuring BP at home do a better job of keeping healthy numbers than those who only get it measured during visits to their doctors. The importance of the technique has only increased during the age of the new coronavirus.
I’ve also had a special interest in at-home BP measurement that long predates the pandemic. For my entire adult life I have apparently suffered from white coat hypertension. When I go see a doctor, the pattern is absolutely reliable: the first routine blood pressure test shows that I have elevated blood pressure or even hypertension. I’ll ask to run a second test at the end of the visit, and invariably my blood pressure has lowered, usually to a healthy level. I would like to think that the second reading is more indicative of my true blood pressure, but who knows?
And so I was very pleased to try Withings’ at-home smart blood pressure monitor, the BPM Connect. The BPM Connect is a sleek and attractive blood pressure cuff that automatically updates a smart phone app with your data. Setup is a snap, and thereafter fresh blood pressure readings can be conveniently taken with the mere touch of a button.
I found the minimalist design of the monitor very user-friendly. There are no wires or cables, nothing to plug in. Everything—the display, the pump, and the battery—is housed in a single remote-control sized unit, which is attached directly to the cuff. There’s nothing to lose or get confused about. It packs away neatly and would be easy to travel with. The cuff is a handsome heather gray, made of a comfortable and flexible material.
The unit has just one button, and it only takes a couple clicks to begin a blood pressure reading. The experience of the measurement is identical to the BP machines at your doctor’s – pressure builds on your upper arm for less than a minute, releases, and you’re done. The cuff itself displays your BP reading, along with color-coded feedback on the device, and then wirelessly beams the info to the Withings Health Mate app (a free download for both iOS and Android), which organizes your data very conveniently so as to easily track progress or see trends.
I really only had to adjust the cuff once, in order to take my first reading, and can now easily slide it on and off my arm. I keep it on my desk, and whenever I happen to think of it I slide it up my arm and take a reading. And after several weeks I have not yet needed to recharge the unit.
To be clear, there are some questions about the accuracy of at-home blood pressure monitors. They often fall short of the gold standard (the old-school mercury sphygmomanometer). Withings claims that their cuff has been clinically validated to an even tighter range than that required by the FDA’s professional standards.
My impression is that the user can have a significant impact on accuracy according to how much he or she adheres to the instructions. Blood pressure readings should always be taken carefully and in specific circumstances, not ‘off the cuff’ – a guideline that many doctors and nurses fail to observe, by the way. Blood pressure is also highly variable. Tiny, very short term differences in your status can change your readings meaningfully. Over the course of one morning, for example, I took half a dozen readings, which ranged from a 115/77 to a 131/88 (which prompted a yellow “high blood pressure stage 1” warning).
Variable readings don’t indicate that the monitor is inaccurate, they’re just a fact of life. The best way to reduce the impact of apparently unpredictable readings is to test often. Indeed, this is the very reason that so many experts advocate for regular home blood pressure testing. One of my favorite features of the BPM Connect is designed to help reduce the impact of aberrant readings: with just a couple clicks you can instruct the cuff to take three sequential readings.
I have already tried, and enjoyed, two other Withings smart health devices. At this point, the Withings Health Mate app is a one-stop biohacking shop, with all the data I could ever want on my weight, fat %, exercise duration, step counts, blood pressure, pulse, sleep quality, and so on.
So how did I do? I didn’t perfectly resolve the mystery of my white coat hypertension, as I did register a few BP readings that were concerningly high. But for the most part my blood pressure readings were consistent, generally in the higher range of the “healthy” bracket. That’s good enough for me to be fairly well assured that I’m not experiencing high blood pressure on a consistent basis, and that I probably don’t need to be seeking a pharmacological solution.
I was surprised to learn how common the white coat effect is. This remarkable 2006 study from Turkey found that when 258 patients registered high blood pressure at a clinic, an extraordinary 74% of them were revealed to have healthy blood pressure when tested more rigorously, either at the clinic or at home. (One wonders how many of them would have been prescribed medication that they did not really need.) At the same time, 2% of the study participants had the opposite condition, “masked hypertension,” in which the patient has real and sustained and dangerous hypertension that for some reason only shows up at home.
The authors of this study, enjoyably titled “What a High Prevalence of White Coat Hypertension in Society!”, concluded that at-home blood pressure testing is so superior to single-point clinical testing, and so essential to finding these unexpected blood pressure patterns, that everyone over the age of 40 should conduct at-home blood pressure testing.
The Withings cuff is listed at $99.95. If you have a flexible health spending account (HSA or FSA), you can use those bucks to purchase the BPM Connect without a prescription.
With the abrupt rise of telemedicine and an increased emphasis on public health risks, it would seem wise to consider taking that advice. The BPM Connect is well-designed and easy to use. I recommend it.
For more about Withings blood pressure monitor visit Withings.com.
*Disclosure: This is a sponsored post. The author received a blood pressure monitor for review. Opinions are his own.