How to monitor your blood pressure at home

Your blood pressure can lie. It changes throughout the day, but too often, we rely on one blood pressure measurement taken in a doctor’s office.

There often isn’t time to take an accurate blood pressure measurement during a doctor’s visit. To properly take a blood pressure measurement, you need to be relaxed and seated for five minutes. If the measurement is high, you need to wait five minutes and take it again.

It’s often the “relaxed” part that is most difficult. Doctor’s visits can be stressful. This can cause your blood pressure to rise. The phenomenon of blood pressure readings that are higher in a doctor’s office compared to at home is known as “white-coat hypertension,” and it can occur in 15 to 30 percent of patients.

So how do we get a more accurate blood pressure reading? By supplementing office measurements with those taken during your daily routine. There are two ways to do this: manual home blood pressure monitoring and a more formal test known as ambulatory blood pressure monitoring.

Who benefits from home blood pressure monitoring?

I’ve had many patients come to me thinking they had high blood pressure (also known as hypertension) due to measurements taken in a doctor’s office. But after home blood pressure monitoring, I can give them the good news that their blood pressure is, in fact, normal. This monitoring can save them from unnecessary treatment.

Home blood pressure monitoring also can validate high office measurements and allow us to use office time more productively, such as searching for the cause of the hypertension. This could be as simple as your favorite snack food. I once had a patient who loved a certain salty cracker. Once she eliminated the culprit, her blood pressure went back to normal.

Not everyone needs to monitor their blood pressure from home. I recommend it for people who:

  • Have borderline high blood pressure (between 120/80 mm Hg and 140/90 mm Hg)
  • Have high blood pressure (140/90 mm Hg)
  • Take medication for high blood pressure

Along with more accurately diagnosing hypertension, home blood pressure monitoring can track treatment and empower you to take an active role in your health care. With regular monitoring at home, you can see in real time how medication and lifestyle changes affect your blood pressure. And it can help us optimize your care, such as determining whether we need to alter your medication or dosage.

How to monitor your blood pressure at home

Home blood pressure monitoring is easy, but it only works if you do it correctly.

How to choose a home blood pressure monitor

Patients often ask which home blood pressure monitor is best. It doesn’t matter whether you use an arm cuff, wrist cuff or finger measurement. They all work. I tend to find that the wrist and finger monitors are easiest for people to handle because they can do it with one hand and don’t need a helper. Use what’s comfortable for you.

Once you’ve chosen a home blood pressure monitor, bring it to your doctor’s office to make sure you’re using it correctly and to check its accuracy against the doctor’s equipment.

How to check your blood pressure

Timing is everything when checking your blood pressure. If you’re rushing around, that’s not the time to take it. Wait 30 minutes before taking your blood pressure if you:

  • Are about to eat
  • Have just eaten
  • Have exercised recently
  • Have had a caffeinated drink

When you’re ready, sit quietly with your feet flat on the floor. Don’t cross your legs. After five minutes, take your blood pressure. Wait five minutes and do it again to check the accuracy. You can do this three times to get an average of the readings.

How often to measure your blood pressure

You don’t need to do go through this process three or four times a day. When you start, do it on a regular basis so you understand what your blood pressure normally is at different times of the day. Try taking it once in the morning and once in the evening. After that, you can do it periodically. Talk to your doctor about how often to measure your blood pressure.

Home blood pressure monitoring is not a substitute for a doctor’s visit. Keep a journal of your home measurements to show your doctor. Some home blood pressure monitors digitally record your measurements, so you can print them out or send them to your doctor.

How ambulatory blood pressure monitoring works

If there’s uncertainty about the accuracy of your blood pressure readings, we can do a more formal test called ambulatory blood pressure monitoring. We consider this the gold standard to diagnose high blood pressure.

We’ll send you home with an arm cuff to wear. The device measures your blood pressure at regular intervals over 24 hours. This gives us a nice visual chart of your blood pressure throughout the day.

 The information we get from ambulatory blood pressure monitoring and manual monitoring allows you and your doctor to make more effective use of your time together. For example, if your blood pressure is high in my office, but your home readings are normal, we can move on to the next thing. We don’t need to waste time focusing on something that isn’t wrong.

Don’t let one blood pressure measurement lie to you. Request an appointment online or call 844-333-DOCS to talk to a doctor about whether you might benefit from home blood pressure monitoring

Chief of Cardiology, MedStar Heart & Vascular Institute at MedStar Washington Hospital Center
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