Once the decision to start drug treatment of hypertension is made, the aim should be to provide 24 hour BP control, with agents that would encourage patient adherence. The patient and preferably, his family members must be educated about the disease, complications and treatment.
Since the treatment would be long term, great care should be taken to assess the patient's financial status and to tailor the investigations and the drugs suitably. It has been noted that very often, the home blood pressure instruments are either inaccurate or not used properly giving false results. So it is advisable to check on these factors if the patients are asked to do home monitoring.
One of the usual statements made by patient is that when checked by another person, he found to have low BP or high BP. He should be asked to make a note of the exact readings obtained at that time.
There are instances when patients claim that they felt that they had "pressure", when the truth was that he was going through a stressful period. Our practice is to warn the patient that the "pressure" he feels does not necessarily reflect high blood pressure.