Get the most out of home blood pressure monitoring

Checking your blood pressure at home is an important part of managing high blood pressure (hypertension). Home monitoring can help you keep tabs on your blood pressure in a familiar setting, make certain your medication is working, and alert you and your doctors to potential health complications.

Because blood pressure monitors are available widely and without a prescription, home monitoring is an easy step you can take to improve your condition. Before you get started, it's important to know the right technique and to find a good system.

Types of home monitors

Today, most pharmacies, medical supply stores, and some Internet sites have home blood pressure monitors. All monitors have the same basic components — an inflatable cuff or strap, a gauge for readouts and sometimes a stethoscope, depending on the type of monitor you choose.

Cuff. The cuff consists of an inner layer made of rubber that fills with air and squeezes your arm. The cuff's outer layer is generally made of nylon and has a fastener to hold the cuff in place.

Gauge. Blood pressure monitors are either digital or aneroid. The aneroid monitors have a gauge with a dial on it that points at a number related to your blood pressure.

Stethoscope. Some blood pressure monitors come with a stethoscope. It's used to listen to the sounds your blood makes as it flows through the brachial artery in the crook of your elbow. However, without proper training, it's difficult to interpret those sounds. Digital blood pressure cuffs usually have a built-in sensor that records the information for you.

There are a couple types of home blood pressure monitors:

• Manual devices. Manual blood pressure monitors consist of a stethoscope and an inflatable arm cuff connected by a rubber tube to a gauge that records the pressure. To use these monitors, you inflate the cuff that goes around your arm by pumping a bulb at one end of the tube. You then check your blood pressure with a stethoscope — listening for certain benchmark arterial blood sounds — and count your own heart rate. Manual monitors are usually less expensive than digital monitors.

• Digital devices. Digital monitors consist of a cuff and a gauge that records the pressure. The cuff automatically inflates at the touch of a button. These devices automatically calculate heart rate and determine your blood pressure by measuring blood flow. Some even give you an error message if you aren't wearing the cuff properly. Digital monitors also deflate automatically.

  Digital monitors can be fitted on the upper arm, wrist or finger. Arm devices are the most accurate. Avoid devices that measure blood pressure in your finger, because they're not accurate. Wrist blood pressure devices are slightly more accurate than finger devices, but are still not usually recommended. One use for wrist monitors is for those people for whom a large upper arm cuff is too small or can't be used because of shape or pain from the pressure of the cuff when it inflates. Be sure your arm is at heart level when using a wrist monitor.

Talk over the choices with your doctor or nurse so that you pick the monitor that's best for your situation.

Features to consider

Features on home blood pressure monitors can vary widely, from simple manual models to top-of-the-line fully automated devices that allow you to send data to your doctor's office through the phone lines. Here are some general features to consider when choosing a blood pressure monitor:

• Cuff size. Having a properly fitting cuff is the most important factor to consider when purchasing a home blood pressure monitor. Many monitors are available with different-sized cuffs to fit different-sized arms. Poorly fitting cuffs will not give accurate blood pressure measurements. Ask your doctor or nurse what cuff size you need.
• Display. The display that shows your blood pressure measurement should be clear and easy to read.
• Stethoscope. If you get a monitor with a stethoscope, you must be able to place it correctly in your ears and to clearly hear the sounds through it. You must also know how to interpret those sounds — something your doctor or nurse can teach you.
• Accuracy. Check with your doctor or the manufacturer to be sure the monitor has been validated, meaning its readings are accurate and repeatable. Only validated instruments can be relied on for accurate readings.
• Cost. Your health insurance may not cover the cost of a home blood pressure monitor. Prices can vary from as little as $25 for manual monitors to over $100 for automatic devices that come enhanced with memory and electronic printout ability.

Long-term payoffs

If your blood pressure is well controlled, you may need to check it at home only a few days each month. If you're just starting home monitoring, if you're making any changes in your medications or other treatments, or if you have another health problem, such as diabetes, you may need to check it more often.

Home blood pressure monitoring is not a substitute for visits to your doctor. Even if you get normal readings, don't stop or change your medications or alter your diet without talking to your doctor first.

Monitoring your blood pressure at home doesn't have to be complicated or inconvenient. You might even find that you enjoy tracking your readings and that home monitoring gives you more control over your condition. And in the long run, you may risk fewer complications related to high blood pressure and enjoy a healthier life.

Exposing a tumor to air during surgery causes cancer to spread.

Surgery is one of medicine's main weapons against cancer. It can't cause cancer or cause it to spread. Because you may feel worse during your recovery than you did before surgery, you might believe your surgery caused your cancer to spread. However, "air hitting the tumor" doesn't cause cancer to spread. In some animal studies, removing the main tumor mass sometimes temporarily facilitates growth of cancer that has already spread (metastasized), but this hasn't been seen conclusively in humans.

Some tumors will grow to a certain size and become relatively dormant. This occurs if the tumors secrete a substance called endostatin, which suppresses tumor growth in both the primary tumor as well as in distant sites.

Unfortunately all tumors, no matter what their size, secrete angiostatin, which promotes tumor growth — particularly the growth of new blood vessels that supply oxygen and nutrients to the tumor. Therefore, if you have a large primary tumor and only microscopic metastases, the endostatin produced by the large tumor may prevent the metastases from growing. But if you remove the main tumor, you remove the source of growth-inhibiting endostatin, and the metastases, which produce angiostatin, may continue to grow.

Although it's possible that during surgery your doctor may find the cancer more widespread than previously thought, an operation can't cause cancer to spread nor can it cause cancer to start. Don't delay or refuse treatment because of this myth. Surgically removing cancer is often the first and most important treatment.

A positive attitude is all you need to beat cancer.

Although many popular books on cancer talk about fighters and optimists, there's no scientific proof that a positive attitude gives you an advantage in cancer treatment or improves your chance of being cured.

What a positive attitude can do is improve the quality of your life during cancer treatment and beyond. You may be more likely to stay active, maintain ties to family and friends, and continue social activities. In turn, this may enhance your feeling of well-being and help you find the strength to deal with your cancer. A positive attitude may also help you become a more informed and active partner with your doctor during cancer treatment.

Drug companies and the Food and Drug Administration (FDA) are blocking or withholding new cancer treatments.

Going through cancer treatment is never easy. Even when things are going well, it's natural to become frustrated and wish for a magic bullet to cure your cancer. You might even wonder if such a treatment is being withheld.

That's not the case. Your doctor and the FDA, which must approve new drugs before they can be marketed, are your allies. As such, they make your safety a high priority. Unfortunately, scientific studies to determine cancer treatment's safety and effectiveness take time. That may create the appearance or lead to reports that effective new treatments are being blocked. However, the thorough testing required has kept many unsafe and ineffective drugs from being used in the United States.

Hiding or withholding an important treatment advance would be difficult because the public has many ways to access medical information. In addition to verbal, print, video and electronic means, you may even gain access to information about experimental treatments by participating in a clinical trial.

If you still believe a cure is being purposefully withheld, ask yourself why a doctor may choose to specialize in cancer research. Oftentimes doctors go into cancer research because they have a family member or friend affected by the disease. They're just as interested in finding a cure as anyone else, for exactly the same reason — it affects them personally. They hate to see a loved one in pain and don't wish to lose this person. They also want to spare others what they have gone through.

As to suggestions that organizations keep cures a secret because they would otherwise lose their sources of funding, human nature makes this scenario highly unlikely. It is indeed an unusual human being who would pass up the prestige associated with finding a cure in order to keep funds flowing to a research organization. A cancer cure could easily be sold for very large profits and would have the potential to bring in even more money than current treatments.

Undergoing cancer treatment means you can't live at home, work or go about your usual activities.

Most people with cancer are treated on an outpatient basis in their home community. At times it may be helpful to travel to a specialty medical center for treatment. But often, doctors at such a medical center can work with doctors in your hometown so that you can be with your family and friends and perhaps even resume work. In fact, many people do work full or part time during their treatment. A great deal of time and effort has gone into making it easier for people to live more normal lives during their treatment. For example, drugs are now available to help better control nausea. The result is you're often able to work and stay active during your treatment.

A needle biopsy can disturb cancer cells, causing them to travel to other parts of the body.

There's no conclusive evidence that needle biopsy (fine-needle aspiration) causes cancer cells to spread (metastasize). This procedure is sometimes used to diagnose cancer. It involves inserting a thin, hollow needle connected to a syringe into a suspicious lump and removing fluid and tissue for further examination.

For many years, there has been concern that needle biopsy may disturb cancer cells and cause them to spread. However, a study published in 2004 compared people who did and didn't have a needle biopsy before cancer treatment. Those who had the procedure showed no increased spread of cancer.

Everyone who has cancer has to have treatment.

It's up to you whether or not you want to treat your cancer. You can decide this after consulting with your doctor and learning about your options. A person with cancer might choose to forgo treatment if he or she has:

• A slow-growing cancer. Some people with cancer might not have any signs or symptoms. Lab tests might reveal that the cancer is growing very slowly. These people might choose to wait and watch the cancer. If it suddenly begins growing quicker, treatment is always an option later. Keep in mind, though, that not treating the cancer makes it harder to stop it from spreading.
• Other medical conditions. If you have other significant illnesses you may choose not to treat your cancer, as the cancer may not be the biggest threat to your health. This may be especially true in the case of a slow-growing cancer.
• A late-stage cancer. If the burden of treatment side effects outweighs the benefit that treatment can bring, you might choose not to be treated. But that doesn't mean your doctor will abandon you. Your doctor can still provide comfort measures, such as pain relief.