High blood pressure (hypertension)

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Get the most out of home blood pressure monitoring

Features to consider

Features on home blood pressure monitors can vary widely, from simple manual models to top-of-the-line fully automated devices that allow you to send data to your doctor's office through the phone lines. Here are some general features to consider when choosing a blood pressure monitor:

  • Cuff size. Having a properly fitting cuff is the most important factor to consider when purchasing a home blood pressure monitor. Many monitors are available with different-sized cuffs to fit different-sized arms. Poorly fitting cuffs will not give accurate blood pressure measurements. Ask your doctor or nurse what cuff size you need.
  • Display. The display that shows your blood pressure measurement should be clear and easy to read.
  • Stethoscope. If you get a monitor with a stethoscope, you must be able to place it correctly in your ears and to clearly hear the sounds through it. You must also know how to interpret those sounds — something your doctor or nurse can teach you.

  • Accuracy. Check with your doctor or the manufacturer to be sure the monitor has been validated, meaning its readings are accurate and repeatable. Only validated instruments can be relied on for accurate readings. You should bring your monitor to your doctor's office to compare the measurements your monitor gives you with the measurements taken at your doctor's office. Do this yearly to make sure your monitor is still working properly.

    One way to choose an accurate monitor is to check the lists of validated home blood pressure monitors available from the Dabl Educational Trust and the British Hypertension Society. These organizations have tested many types of monitors and post their findings on their Web sites. Keep in mind, however, that if the monitor you use doesn't appear as a recommended monitor on the lists, it doesn't mean your monitor isn't effective — only that it hasn't been reviewed by the organizations.

  • Cost. Your health insurance may not cover the cost of a home blood pressure monitor. Prices can vary from as little as $25 for manual monitors to over $100 for automatic devices that come enhanced with memory and electronic printout ability.

Tips for accurate use

No matter what type of home blood pressure monitor you choose, proper use requires some practice and training. Take the device to your doctor or nurse to make sure the one you've chosen is the best fit for you and to learn how to use the monitor correctly and keep it calibrated so that it continues to give you accurate readings.

You can also follow these tips to help ensure accuracy when you measure your blood pressure at home:

  • Before using a monitor for the first time, have your doctor or nurse check its accuracy against the office model. Also have your doctor or nurse watch you use the device to see if you're doing it properly. If you drop the device or damage it, take it in to be checked before using it again, as it may no longer work properly.
  • You should measure your blood pressure twice daily, once in the morning before you take any medications, and once in the evening. Your doctor may recommend you try to take your blood pressure at the same times of day each time you measure it. Always use your left arm when taking your blood pressure.
  • Your blood pressure is at its highest first thing in the morning, so it might not be a good idea to measure it right after you wake in the morning. Wait an hour or so. If you exercise after waking, take your blood pressure before exercising.
  • Avoid food, caffeine, tobacco and alcohol for 30 minutes before taking a measurement. Also, go to the toilet first. A full bladder can increase blood pressure slightly.
  • When you're ready to take your blood pressure, sit quietly for three to five minutes beforehand. Sit in a comfortable position with your legs and ankles uncrossed and your back supported against a chair.
  • Rest your arm, raised to the level of your heart, on a table, desk or chair arm. You may need to place a pillow or cushion under your arm to elevate it high enough. Place the cuff on bare skin, not over clothing. Rolling up a sleeve until it tightens around your arm can result in an inaccurate reading, so you may need to slip your arm out of the sleeve.
  • Don't talk while taking your blood pressure. Take a repeat reading two to three minutes after the first one to check accuracy. You can wait as little as one minute in between your readings. If your monitor doesn't automatically log blood pressure readings or heart rates, write them down in your own log.

Your blood pressure at home is usually slightly lower than it is in a medical office, typically by a measurement of about five points. For instance, a reading at home of 135/85 millimeters of mercury (mm Hg) is about the same as 140/90 mm Hg at the doctor's office.

Talk to your doctor about what your home blood pressure goal is. If you have diabetes, chronic kidney disease or cardiovascular disease, you may need a goal lower than that of someone without these conditions.

Blood pressure varies throughout the day, and readings are often a little higher in the morning. But contact your doctor if you have any unusual or persistent increases in your blood pressure. Also ask what reading should prompt an immediate call to the medical office. In addition, if your home reading shows that your blood pressure is higher than normal and you experience symptoms such as severe headache, chest pain, numbness or tingling in the face or limbs, contact your medical office immediately or seek emergency treatment.

Long-term payoffs

If your blood pressure is well controlled, you may need to check it at home only a few days each month. If you're just starting home monitoring, if you're making any changes in your medications or other treatments, or if you have another health problem, such as diabetes, you may need to check it more often.

Home blood pressure monitoring is not a substitute for visits to your doctor. Even if you get normal readings, don't stop or change your medications or alter your diet without talking to your doctor first. But, with continued home monitoring, you may be able to make fewer appointments with your doctor if home monitoring shows your blood pressure is under control.

Monitoring your blood pressure at home doesn't have to be complicated or inconvenient. You might even find that you enjoy tracking your readings and that home monitoring gives you more control over your condition. And in the long run, you may risk fewer complications related to high blood pressure and enjoy a healthier life.

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July 11, 2008

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