- With Mayo Clinic emeritus hypertension specialist
Sheldon G. Sheps, M.D.
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Sheldon G. Sheps, M.D.
Sheldon Sheps, M.D.
Dr. Sheldon Sheps, emeritus professor of medicine and former chair of the Division of Nephrology and Hypertension in the Department of Medicine at Mayo Clinic, has been with Mayo Clinic since 1960.
Dr. Sheps, a Winnipeg, Manitoba, native, is board certified in internal medicine and specializes in hypertension and peripheral vascular diseases. He developed a multidisciplinary approach with specially trained nurses, dietitians, technicians and educators to help form a team approach to the treatment of patients with abnormal blood pressure.
"I have always believed in involving the patient and family in their health care," Dr. Sheps says. "I have asked for their understanding of the illness and issues and for participation in decisions. The Web is a natural extension of that, and now many more people can be informed."
Dr. Sheps chaired the sixth working group, and he participated in the fourth, fifth and seventh groups that developed the then-latest guidelines for hypertension under the auspices of the National Heart, Lung, and Blood Institute (NHLBI). He helped write the latest American Heart Association (AHA) report on blood pressure measurement. He chaired an AHA group that produced an online accreditation for blood pressure measurement for health professionals.
Dr. Sheps has co-authored books, newsletters, CD-ROMs and other Mayo Clinic health information material. He joined Mayo Clinic's Web team in 1998. He was medical editor-in-chief of both editions of the "Mayo Clinic on High Blood Pressure" book; the last edition was published in 2003. He was also medical editor-in-chief of "Mayo Clinic 5 Steps to Controlling High Blood Pressure," published in 2008.
In addition, Dr. Sheps was section editor for each of the first three editions of "Hypertension Primer" for the American Heart Association.
Dr. Sheps was also chairman of the Science Base Subcommittee and the National High Blood Pressure Education Program, and he was a consultant to the Hypertension Initiative of the World Health Organization. In 1997, he was honored with the Individual Achievement Award on the 25th anniversary of the National High Blood Pressure Education Program of NHLBI. In 2009, he was honored as a Distinguished Mayo Alumnus.
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Lifestyle and home remedies (11)
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Alternative medicine (2)
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Question
Blood pressure readings: Why higher at home?
My blood pressure measurements at home are always higher than at my doctor's office. Am I doing something wrong?
Answer
from Sheldon G. Sheps, M.D.
Blood pressure measurements that are higher at your home than at your doctor's office could be caused by a decrease in stress at your doctor's office or an error in measuring your blood pressure at home.
The opposite, higher blood pressure at your doctor's office than at your home, is often called white-coat hypertension. This means that the stress or anxiety of being in your doctor's office causes your blood pressure to be higher than it normally is at home, where you feel more at ease.
Having lower blood pressure measurements at the doctor's office than at home is called masked hypertension. Masked hypertension can occur if a calm, quiet environment at your doctor's office is less stressful than the environment at home — leading to a lower blood pressure reading at the doctor's office. Likewise, use of alcohol, caffeine or cigarettes at home can increase blood pressure.
Be sure that your home blood pressure monitor is accurate and that you're using correct technique. If you're not sure, ask your doctor. He or she may ask you to bring the home blood pressure monitor to the office. You may measure your blood pressure in one arm with the home monitor while your doctor measures your blood pressure in the other arm with the office equipment.
Still, some people consistently get different blood pressure readings outside the doctor's office — even when blood pressure is measured correctly and repeatedly. If your home blood pressure readings are accurate and consistently higher than those at your doctor's office, your doctor will likely manage your blood pressure based on the higher readings.
Next questionBlood pressure: Does it have a daily pattern?
- Home blood pressure monitoring. American Heart Association. http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/SymptomsDiagnosisMonitoringofHighBloodPressure/Home-Blood-Pressure-Monitoring_UCM_301874_Article.jsp. Accessed Feb. 5, 2013.
- Kaplan NM, et al. Overview of hypertension in adults. http://www.uptodate.com/home. Accessed Feb. 6, 2013.
- Pickering TG, et al. Call to action on use and reimbursement for home blood pressure monitoring: Executive summary: A joint scientific statement from the American Heart Association, American Society of Hypertension, and Preventive Cardiovascular Nurses Association. Hypertension. 2008;52:1.
- Ogedegbe G, et al. Masked hypertension: Evidence of the need to treat. Current Hypertension Reports. 2010;12:349.
- Pierdomenico SD, et al. Prognostic value of white-coat and masked hypertension diagnosed by ambulatory monitoring in initially untreated subjects: An updated meta-analysis. American Journal of Hypertension. 2011;24:52.
- How to monitor and record your blood pressure. American Heart Association. http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/SymptomsDiagnosisMonitoringofHighBloodPressure/How-to-Monitor-and-Record-Your-Blood-Pressure_UCM_303323_Article.jsp. Accessed Feb. 6, 2013.
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