After the doctor has explained the nature of the disease to the patient and discussed the treatment plan with him he will ask him to come for regular periodic check-ups. At first, until the pressure is brought down to the level appropriate to his age or as close to it as possible, he will probably ask to see him more frequently, particularly since the lowering of the pressure is a gradual process requiring constant checking. These frequent visits also afford the patient the opportunity to ask the doctor all the questions.
The actual blood pressure measurement is only one aspect of these visits. Your blood pressure, whether treated or not, can vary, depending on the time of day, the weather, and any number of physical and psychological conditions. So it does not say very much about either the success or failure of the therapy if on different days the systolic pressure varies from 20 to 40 mm Hg and the diastolic pressure from 10 to 20 mm. What matters is whether the elevated pressure is the exception or the rule. Therefore the doctor at first will want to take as many readings as possible to help him to understand his patient's condition. However, the kind of close control, so desirable especially in the case of severe hypertension, is not always possible.
In recent years an increasing number or patients have been taught to check their blood pressure themselves. Initially doctors had great misgivings about this approach, but the results have generally been so encouraging that more and more patients are being instructed in it. The fear that patients may develop a control neurosis have proved groundless. The danger is no greater than with diabetics who check themselves. The home measuring has proved highly effective with patients suffering from severe and particularly malignant hypertension and with patients who had trouble bringing their pressure down to satisfactory levels. The spontaneous variation of the pressure which can show up in the comparatively infrequent checks by the doctor can give a distorted picture whereas regular home measurement can give a far more accurate picture and assist the doctor in developing a better, less hazardous drug program. There is also a hidden psychological advantage. By becoming involved personally the patient turns from a passive treatment object into an active assistant of the doctor. Ask your doctor whether home measurement would be advisable for you.
Once the blood pressure has been brought down the patient does not have to see the doctor more often than every few months. On that occasion he will check your heart and circulation, other risk factors as well as lab reports that might detect undesirable side effects.
*29\336\2*
