Everyone with high blood pressure, about 72 million Americans, should own a home monitor and do regular pressure checks, the American Heart Association and others urged yesterday in an unprecedented endorsement of a medical device for consumers.

High blood pressure is a leading cause of heart attacks, strokes and death. Having it checked a few times a year in a doctor's office or at the drugstore is not enough to keep tabs on it, and regular home monitoring is more accurate, the new advice says.

Closer checks would let doctors fine-tune the many medicines used to control high blood pressure, just as diabetics adjust their insulin levels by regularly monitoring blood sugar. Only a third of people with high blood pressure now have it under control.

"Our current approach is simply not working," said David Goff, a preventive-medicine specialist at Wake Forest University and a member of the panel that wrote the advice.

Outside experts strongly agreed. But some said the case would be more compelling if those pushing the monitors had no industry ties.

Home monitors cost $50 to $100 on the Internet and at pharmacies. Insurance usually doesn't pay, though the heart groups say it should.

The American Heart Association, the American Society of Hypertension, and the Preventive Cardiovascular Nurses' Association all urged home monitoring in a statement online in the journal Hypertension.

The condition occurs when blood pulses too forcefully through vessels, which can damage the heart, kidneys and other organs.

Readings of 140 over 90 are considered high at the doctor's office, 135 over 85 if taken at home. Pressure often goes up with the "white coat" effect, nervousness when seeing a doctor.

Home monitors can give a better picture of pressure variations and response to a drug.

Automated, arm-cuff devices are recommended - wrist and finger ones are notoriously inaccurate. People should take their device with them to their doctor's office and have measurements compared.