Choosing Home Blood Pressure Monitor
Fifteen years ago, blood pressure monitors were considered hands-off for patients. Now physicians prescribe home monitoring for their patients with high blood pressure. Keeping tabs on pressure can motivate patients to take medicine, encourage them to watch their diet and reduce the frequency of doctor’s office visits.
Choosing a blood pressure monitor, however, is no easy task. At least 12 companies now manufacture four different types of home monitors that vary widely in cost.
To sort out the confusion, researchers Gary R. Schmidt and Joan Hoettels Wenig rate monitors for accuracy, ease of use, durability and costs in an evaluation just released by the American Pharmaceutical Assn. Here’s what shoppers need to know before heading to the corner pharmacy:
Mercury monitors, priced at $40-$75, are the most accurate and durable.
Aneroid monitors, priced at $15 to $40, aren’t as accurate, but, according to study co-author Schmidt, they are reliable enough for most patients. Users listen for the sounds of blood flow and read measurements on a calibrated dial.
But an electronic monitor, which converts the blood flow sounds electronically to a reading, are more convenient for patients with hearing loss, vision problems or coordination difficulties. Priced at $70 to $400, the fragile monitors are, however, more costly.
Finger monitors, in which a cuff is placed over the index or middle finger, are lowest on the reviewers’ list. They cost $100 to $150.
Despite the affordability of monitors, everyone doesn’t need to jump on the bandwagon. “I would only recommend home monitoring for hypertensive or borderline hypertensive patients,” says Schmidt, a hypertension research coordinator at the William S. Middleton Veterans Administration Hospital in Madison, Wisc. “And then, only with proper instruction from a doctor or nurse.”
To make sure home measurements are accurate, Dr. Wayne Flicker, a physician at Cigna Healthplans of California, asks patients to bring their monitors to his office periodically. Flicker puts his office blood pressure monitor on one arm; the patient puts the home monitor on the other. If the readings jibe, Flicker is satisfied.
Detergent Danger
Even the most safety-conscious parents think laundry detergent poses little poisoning risk. But today’s nonphosphate detergents are so alkaline that even small amounts can damage children’s gastrointestinal tract and cause severe respiratory problems, say doctors from the Children’s Hospital National Medical Center in Washington.
Reporting recently in the journal Pediatrics, the researchers described eight cases of children who were hospitalized after eating or inhaling the detergent. Unfortunately, symptoms such as swelling, difficulty in breathing and fever don’t always occur immediately after the poisoning. One child’s lip didn’t swell until five hours after the accident. Other children didn’t start drooling or coughing until an hour later.
But laundry detergent isn’t the only overlooked household poison, cautions Frances Weindler of the L.A. County Medical Assn.’s Regional Poison Control Center who has gotten several frantic calls after children ate automatic dishwasher detergent: “Even a little can cause damage.”
The best action after such poisonings, Weindler says, is to examine the mouth for any burned or reddened areas. “If there are any,” says the poison expert, “call the doctor or the emergency room.”
After Sterilization
The type of sterilization surgery a woman undergoes may significantly affect her menstrual period, suggests a study recently published in the journal Fertility and Sterility.
In the study of 227 sterilized women and 219 control subjects, those women whose Fallopian tubes were cauterized (burned) had heavier menstrual bleeding one year after surgery than those whose tubes were closed off by banding or ligating (tying). The evidence suggests that cauterization may be associated with adverse changes in menstrual patterns, conclude the researchers from the University of Texas Health Science Center and the Transnational Family Research Institute, Palo Alto.
When deciding which sterilization procedure is best for a woman, doctors take other factors into account besides the effect on menstruation, points out Dr. Gerald Zatuchni, a contraceptive expert who is professor of obstetrics and gynecology at Northwestern University. Cauterization, for example, is considered much less reversible than banding or ligation and has a higher success rate. For those reasons, cautery is often considered the best choice for older women.
Women should not be alarmed over the new study, adds Zatuchni, because the results are preliminary.
Jet-Lag Attitudes
When an ordinarily cheerful Los Angeles woman and her 18-year-old son returned from a three-week European vacation, she became impatient, even crabby, for four days.
“Jet lag gets you out of rhythm, and when people get out of rhythm, they tend to become negative and argumentative,” says Gary Emery, a Los Angeles psychologist. Research also suggests, adds Emery, that most family arguments occur between 5-7 p.m., a transitioning time from work to home that the psychologist compares to having “mini jet lag.”
