Did you know nearly half of all American adults have high blood pressure?
And CDC statistics show that nearly 75% of those 60 and older have some form of high blood pressure, often due to age-related stiffening of the arteries.
Untreated hypertension can lead to heart attack and stroke, which makes monitoring your loved one’s blood pressure an important preventive tool. While high blood pressure is an issue for many seniors, low blood pressure can also be a concern.
“Of note, we talk a lot about high blood pressure, but low blood pressure can be just as dangerous if it makes a person at higher risk of falls,” said Dr. Jessica Kalender-Rich, MD, a geriatrician with the University of Kansas Health System. “We physicians are always looking for the sweet spot, especially in older adults, where the blood pressure is within a range of safety.”
One easy way older adults can track blood pressure is through the use of a blood pressure kiosk often found at your local pharmacy. But are blood pressure kiosks really a good way to track blood pressure?
Are the results valid?
The answer to that question? It depends. Clinical research shows that, in general, most blood pressure kiosks aren’t great at providing accurate results. That’s because most blood pressure kiosks don’t take arm size into account.
“Older blood pressure kiosks found in pharmacies are not independently validated for accuracy, and can’t be considered clinical-grade,” said Josh Sarkis, chief strategy officer for kiosk maker PharmaSmart. “They might be accurate on some adults, but they are not designed for large or small arms, meaning a large percentage of folks are using them off-label and may not be getting accurate results.”
Kalender-Rich agrees: “Blood pressure kiosks are very one-size-fits-all. Thus, a person at the extremes of arm size is less likely to get an accurate reading.”
Part of the issue is the way blood pressure kiosks are categorized under federal regulations. While the devices are FDA-cleared, they aren’t “approved” like medications, and they are not directly tested by the FDA for accuracy. This means many blood pressure devices (both home and kiosk) are never properly validated through independent testing.
…many blood pressure devices (both home and kiosk) are never properly validated through independent testing.
“FDA clearance of a device doesn’t mean it’s accurate,” Sarkis said.
The lack of standards for accuracy on these devices has troubled the clinical community so much that the American Medical Association worked with doctors, industry experts and the FDA to create its own validation criteria and Validated Device Listing (VDL) for blood pressure kiosks and other at-home blood pressure monitors.
The AMA’s criteria include independent validation testing to prove the accuracy of these kiosks and home monitors for all arm sizes.
“In the U.S., there has never been a regulatory requirement for independent clinical validation of blood pressure devices,” Sarkis said. “This is why respected national lists such as the VDL are so important in deciding what blood pressure devices to use.”
All this means if you’re going to use a blood pressure kiosk to track the blood pressure of a loved one, you need to know which device you’re using. You can see the AMA’s list of validated devices at validatebp.org.
…if you’re going to use a blood pressure kiosk to track the blood pressure of a loved one, you need to know which device you’re using.
You can also ask at your local pharmacy about the validity of their kiosk. Currently, PharmaSmart kiosks are the only ones on the VDL.
“People should ask, ‘Is this a validated device?’” Sarkis said. “Not all devices are clinically validated, and it’s ‘user beware.’ They should be asking their pharmacist, ‘Is this device on the National Blood Pressure Validated Device List?’ and ‘Is the kiosk cuff designed for my arm size?’”
Kiosk makers are making changes. For example, PharmaSmart’s blood pressure kiosks have a patented cuff that provides accurate results for different arm sizes.
“We’d like to see every U.S. pharmacy upgrade to clinical-grade kiosks, so that 300,000 pharmacists will have the tools they need to reduce national rates of high blood pressure,” Sarkis said.
Why does it matter?
You might be thinking, “Why do I need to worry about the validity of the drug store blood pressure machine? I’ll just get my blood pressure checked at the doctor.”
Believe it or not, hypertension is difficult to diagnose in the doctor’s office. Just the act of going to the doctor can elevate some people’s blood pressure, as anxiety associated with the visit can cause false blood pressure readings. This is often called white coat syndrome.
This is why doctors won’t diagnose high blood pressure without three to four in-office readings and why tracking your blood pressure outside of the doctor’s office can help both in diagnosis and treatment.
…doctors won’t diagnose high blood pressure without three to four in-office readings
In fact, the 2020 International Society of Hypertension Global Hypertension Practice Guidelines states, “Out-of-office BP measurement is often necessary for the accurate diagnosis of hypertension and for treatment decisions.”
Getting valid blood pressure readings outside of your doctor’s office is an important tool for the diagnosis and treatment of high blood pressure, which could end up saving your life.
Getting valid blood pressure readings outside of your doctor’s office is an important tool for the diagnosis and treatment of high blood pressure, which could end up saving your life.
Tracking your blood pressure outside of your doctor’s office is also important to make sure the prescribed treatment is working, and Sarkis said routine measurement will improve compliance with a treatment program.
“The data shows that if you’re measuring, you are much more likely to comply with your meds,” he said.
Why use a kiosk?
Blood pressure kiosks are convenient and easy to use, and they’re often located in a place your loved one will be on a regular basis anyway. But it’s important to know how to get the most accurate readings.
“Blood pressure kiosks can be very valuable when used correctly,” Kalender-Rich said. “First, the person should sit calmly for a short time before using it. Second, it needs to be the right size cuff, which can be difficult to tell. For this reason, people with very small or very large arms should likely not use a kiosk version.”
Newer kiosks like the version from PharmaSmart also feature online capabilities that can send your validated results to your pharmacist or to an app, making it convenient to track your blood pressure and pass along the information to your doctor.
Blood pressure kiosks both now and in the future can be an important tool for seniors. However, it shouldn’t replace regularly checking in with your doctor.
“People should not rely only on kiosk measurements; it is important to continue to see their physician regularly,” Kalender-Rich said. “Physicians can also provide each person with their individualized goal blood pressure range because some people may have lower or higher goal ranges based on other medical problems. Additionally, people who may have added anxiety or stress from an abnormal reading should talk to their doctor before consistently using a kiosk. And last, it’s always important to consult one’s physician prior to starting any new regimen.”
…people should not rely only on kiosk measurements; it is important to continue to see their physician regularly.