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Getting a Grip on Blood Pressure: DHMC Program Offers Free Screenings as Way to Control Health Expenses

Larry Kirkpatrick of Dartmouth checks his blood pressure in a cubicle set up as a blood pressure monitoring station at DHMC in Lebanon, N.H., on August 8, 2013. Kirkpatrick uses the station at the hospital every time he visits, usually once a week, and also monitors his blood pressure at home. 

Valley News - Sarah Priestap

Larry Kirkpatrick of Dartmouth checks his blood pressure in a cubicle set up as a blood pressure monitoring station at DHMC in Lebanon, N.H., on August 8, 2013. Kirkpatrick uses the station at the hospital every time he visits, usually once a week, and also monitors his blood pressure at home. Valley News - Sarah Priestap Purchase photo reprints »

Lebanon — They call high blood pressure the “silent killer,” one of those things that no one pays attention to until it’s too late.

Larry Kirkpatrick never gave his blood pressure much thought until four years ago, when he learned that his kidneys were failing him.

“That’s when I really became aware of it,” said Kirkpatrick, a 66-year-old Grantham resident. “But it didn’t do me that much good then because my kidneys were shutting down.”

He pays attention to it now, though. Since Kirkpatrick underwent a kidney transplant last year, he checks his blood pressure several times a week. But he doesn’t need to make an appointment with his doctor to do this. He can just go to Dartmouth-Hitchcock Medical Center, or the primary care facility on Heater Road, walk into a private room and do it himself.

Last month, DHMC began offering a free service for anyone — whether or not they seek care at DHMC — to walk in and check their blood pressure. No appointments necessary, all self-serve and the results can be included in a person’s patient record.

The aim is to provide a simple, easily accessible way to monitor something that could lead to earlier detection and treatment of a problem that affects one out of every three adults in the United States, said Tayna Luttinger, a family physician at Dartmouth-Hitchcock.

The free service is part of Dartmouth-Hitchcock’s goals to improve the health of the general population, she said.

“We hope with this to have a resource that anybody in the community can use,” she said. “We just wanted to make it available.”

Blood pressure is a measure of how hard the blood is pushing against the walls of your arteries as it moves through the body. If the pressure stays high, you have high blood pressure, also called “hypertension.” It has been linked to kidney disease, as well as heart disease and stroke, which are leading causes of death in this country.

About 800,000 people die of cardiovascular disease and stroke in the U.S. every year, according to the Centers for Disease Control and Prevention. Lowering your blood pressure is one way to reduce risk.

Monitoring blood pressure is relatively simple and should be done regularly, similar to measuring a person’s weight, health experts say. That way, if patients notice their numbers creeping up, they can make lifestyle changes right away in order to address it.

New research published Aug. 6 in the journal Annals of Internal Medicine found that patients who self-monitored their blood pressure had better results in controlling hypertension.

But many people don’t know they have high blood pressure until after they have some kind of other problem. And, as Kirkpatrick discovered, that can be too late.

Self-monitoring blood pressure rooms have been set up at the main DHMC campus on Route 120 as well as the new primary care facility that opened last year on Heater Road.

The process takes a few minutes. A patient walks in, shuts the door and follows the step-by-step directions on how to use the equipment. He or she slips one of the inflatable cuffs over his or her arm, presses a button and the machine takes a minute to measure his or her blood pressure. When finished, patients can make a small printout about the size of a store receipt with the results.

Then, if the person is a DHMC patient, he or she can staple the results to a short form with her information and put it in a locked box. The box is checked every day and the results included in the patient’s electronic medical record, Luttinger said.

So far, only a handful of people have been using it, but Luttinger expects the numbers to grow.

A chart on the wall and pamphlets explain how to read the blood pressure results. The top number, or “systolic” measure, shows how hard the blood pushes when the heart is pumping. The bottom “diastolic” number is how hard the blood pushes between heartbeats. Normal is anything with a systolic number below 120 and diastolic below 80. Hypertension would be where the systolic number is above 140 or the diastolic is over 90.

Posted on a cork board above the machine is an advice guide. If, for example, someone registered 180/110 or higher, the instructions are to “call your doctor TODAY to report the reading and ask for advice.” Even if a person is in the normal range, she is told to bring the results to her next appointment.

If someone tests for very high blood pressure, nurses are available to help the patient measure again. If the numbers remain high, then DHMC staff would help connect that person with a doctor, Luttinger said.

Molly Castaldo visited the self-monitoring room recently on the DHMC campus. The 50-year-old Hanover resident doesn’t have high blood pressure and has never really been concerned about it. But she understands the importance of keeping watch over it, especially as she gets older. Castaldo and Kirkpatrick are both patient representatives on a committee at DHMC that helped establish the self-monitoring blood pressure rooms.

Castaldo has seen something similar offered via kiosks at drug store such as CVS. But the privacy of the DHMC rooms made her feel more at ease.

“I just felt like, from my perspective, sitting in a room where I could close the door, I could relax and sort it out for myself” was better, she said.

A patient’s comfort level is not trivial and could affect the results. A nervous person with a fast-beating heart is going to have higher blood pressure than when that same person is calm and resting. Some patients record higher blood pressure when they visit the doctor because they are nervous — the so-called “white coat” effect. The private rooms could help get more accurate readings.

Monitoring is only the first step in helping patients with hypertension, but DHMC providers hope it will boost awareness of the issue. Then, patients with high blood pressure can begin addressing it with changes in their diet and exercise.

“It’s so simple to check your blood pressure,” Kirkpatric said. “Yet, by not monitoring it, the results can be devastating.”

Chris Fleisher can be reached at 603-727-3229 or cfleisher@vnews.com.