When winter begins, BP readings can rise. How much does it matter?

With the winter season, your patients’ BP readings may go up.

The winter season can exacerbate the complexities of treating hypertension. From physiological responses to lifestyle adjustments, the winter months introduce a unique set of hurdles that could influence the efficacy of treatment regimens and further complicate the delicate balance required in managing high blood pressure, according to research presented at this year’s American Heart Association Hypertension Scientific Sessions.

Members of the AMA’s Improving Health Outcomes group reviewed electronic health records for 60,676 adults who were being treated for hypertension between 2018 and 2023 at six U.S. health care organizations.

Among patients with hypertension, systolic blood pressure rose by up to 1.7 mm Hg during the winter season compared with the summer months. Meanwhile, BP-control rates during an outpatient visit decreased by nearly 5% in the winter, compared with the summer. Blood pressure control was defined in this study as less than 140/90 mm Hg among patients with hypertension.

Here are some steps physicians and care teams can take to help improve BP control among their patients during the winter months.

1. Use a validated BP device

   1. Automated, oscillometric blood pressure devices have emerged as a safer and less error-prone device than their manual mercury or aneroid predecessors. They eliminate several sources of user error and bias, tend to maintain calibration longer, and can be used at home or in the absence of health professionals to minimize the white coat effect. Check out the US Blood Pressure Validated Device Listing (VDL™), for a growing list of devices that have been independently verified for accuracy.

2. Encourage at-home BP measurement

   1. Nearly half of U.S. adults have hypertension, and more than three-quarters of these with the diagnosis don’t have it under control. The good news is that self-measured blood pressure, paired with clinical support, has been shown to be effective in helping patients with hypertension lower blood pressure and achieve control.

3. Think twice about cuffless BP devices

   1. The Food and Drug Administration (FDA) has cleared a number of cuffless BP-measurement devices, to which some have responded with enthusiasm for these novel, often wearables devices. However, a device cleared by the FDA does not mean it has been independently tested for clinical accuracy with accepted validation protocol. For now, validated, upper arm devices remain guideline-recommended for the diagnosis and treatment of high blood pressure.

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4. Reduce therapeutic inertia

   1. When it comes to effective treatment of high blood pressure, three common challenges must be confronted: diagnostic uncertainty, therapeutic inertia—failing to start or intensify treatment when BP is high—and treatment nonadherence. To do this, physicians can seek support through AMA MAP™ Hypertension, which is an evidence-based quality improvement program that provides a clear path to significant, sustained improvements in BP control. Find out how the AMA MAP framework can help reduce therapeutic inertia.

5. Recommend improvements in physical activity

   1. Regular physical activity can help prevent a variety of health conditions, including obesity, heart disease, stroke, high blood pressure and type 2 diabetes. Yet a large portion of the U.S. adult population do not meet the recommended levels of daily physical activity. Learn how to get more patients moving more often.

6. Offer nutrition guidance

   1. Nutrition is the foundation of good health, playing a crucial role in improving quality of life. Yet many people in the U.S. don’t eat a healthy diet, which increases risk for obesity, heart disease, type 2 diabetes and other health conditions. That is why it is important to follow proper eating patterns that include nutritious foods and drinks. But with so much conflicting information about what constitutes such a diet, it can be challenging to know where to begin. Here are some tips for patients to follow to make better nutrition decisions.

The AMA has developed online tools and resources created using the latest evidence-based information to support physicians and care teams to help manage their patients’ high BP. These resources are available to all physicians and health systems as part of Target: BP™️, a national initiative co-led by the AMA and American Heart Association.