The Use and Misuse of Automatic Blood Pressure Monitors

I'm a fan of automatic blood pressure monitors like the Omron HEM series. These machines, which have become increasingly accurate and easy to use, allow you to check your own blood pressure automatically at the touch of a button. Most of the time, patients love the reassurance and sense of control these monitors provide.

And sometimes, blood pressure monitors will unmask a rare severe case of "white coat hypertension." In this situation, a person can have a nearly normal blood pressure at home but their blood pressure increases in the doctor's office -- sometimes to over 180/100 -- due to stress caused by seeing the "white coat." In this situation, if medications are given to aggressively treat the high blood pressures in the office, patients may even be at risk of passing out at home from low blood pressure. Automatic blood pressure monitors reveal the difference between the home and office pressures and are enormously helpful in these and other cases.

But rarely, the opposite happens -- the presence of the machine itself causes high blood pressure. The occasional person is so unnerved by their blood pressure monitor that it actually causes their blood pressure to increase. Seeing the high blood pressure reading, in turn, causes them to panic, and they press the button on the machine again and again to take more readings, becoming more and more panicked, which in turn causes their pressure to rise even more. This usually results in a frantic phone call and sometimes a visit to the emergency room.

To prevent this from happening, I tell people to take their blood pressure only once after sitting quietly for five minutes. Thankfully, this usually solves this rarely occurring problem, and the majority of people find automatic blood pressure monitors helpful and reassuring.

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Tech Medicine 2.0

Thanks to Healthline and Enoch Choi -- medblogger extraordinaire and the previous author of Tech Medicine -- for the invitation to write this blog. It's a pleasure to join the diverse group of Health Talk experts writing on topics including reproductive technologies, emergency medicine, cancer, smoking, obstetrics, adolescent health, dieting, fitness, nutrition, and wilderness medicine (with a specialization in snakes).

My goal in Tech Medicine will be to explore the intersection of medicine, new technologies, and the Internet. This is a purposefully broad topic. Several times weekly I will post focused reviews of issues interesting to health professionals and nonprofessionals alike. Future posts may include examinations of medical devices, pharmaceuticals, scientific advances, internet services, and other technologies involving health care and the practice of medicine. Mirroring as it does the nature of the Internet and the sometimes surprising nature of new technologies, the content may also include topics that are wonderful, unusual, hilarious, or strange.

To introduce myself: I'm trained as a nephrologist (a kidney and blood pressure specialist). For the last two years I've written Kidney Notes, a blog designed to filter and process medical news. Most recently, Kidney Notes has become a collection of links, commentary, and scraps of information -- a reference database of interesting things with the help of a popular social bookmarking service called del.icio.us. While I will continue posting to Kidney Notes, several friends have asked me to write longer posts of original content -- and this is what I will be writing on Tech Medicine.

There are many topics I plan to cover, but I'm also open to suggestions and tips. Please email them to techmedicine@gmail.com.

Be well!

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Au Revoir! So Long!

It's been a pleasure sharing with you here over the last year, but all good things must come to an end and lead to new beginnings. I'm handing the reins of Tech Medicine to the very capable Joshua Schwimmer MD, FACP, FASN, (also the author of KidneyNotes)--a blogging friend who's not only from the specialty I have the most respect for in terms of raw brilliance (Nephrology), but also one of those in the medblogosphere who's most on top of technologies that are helpful to those looking for health information. He's surprised me many times with his mastery of social networking and Web2.0 tools and is someone that I think will get asked the question I'm asked all the time: "How do you keep up with all of these new technologies and keep up with medicine?" He's someone that I trust to do both.

The reason I've been so scarce here and elsewhere in the blogosphere is that my work has required more of me. Here's where you'll find me on the web:
My own blogs:
Medmusings where I've waxed poetic for 4 years
My speaking bio woefully in need of an update
Vox where I share more personally

Hope to keep up with you all at Grand Rounds and other Health Blogging / Medbloggin venues.
Until then, enjoy!
- Enoch Choi

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