Blood pressure self-monitoring during pregnancy: practical considerations

Portable electronic and mechanical aneroid instruments for blood pressure self-monitoring are available, inexpensive, and reasonably accurate. Instructing the patient at risk for borderline, mild hypertension or chronic hypertension during pregnancy on self-monitoring of blood pressure has advantages. Combined with conventional office measurements, many daily recordings give an accurate picture of an individual's dynamic blood pressure. Lower blood pressures commonly found outside the office are likely attributable to an increased awareness, less anxiety, and attention by the patient to nonpharmacologic factors. Such persons may well avoid antihypertensive therapy or antepartum hospitalization. This information provides a strong incentive to undertake and adhere to an appropriate plan of treatment for those patients whose hypertension is confirmed by blood pressure self-monitoring technique. We consider blood pressure self-measurement to complement other reported monitoring techniques for active patient participation at home or in the work setting. It also permits an early evaluation of blood pressure alterations to rule out preeclampsia, especially in the pregnant patient with chronic essential hypertension.