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

Is There a Magic Number for High Pressure?

New Guidelines Recommend Higher Targets for Older Adults

Washington, D.C., January 24, 2016One in three adults in the U.S. has high blood pressure. That number climbs to two in three for older adults.

Recently, two medical groups released recommendations that set safe blood pressure targets higher than ever for adults 60 and older – a group at high risk for complications from high blood pressure.

Traditionally, the threshold for high blood pressure has been set at 140/90 mm/Hg. But the new guidelines, from the American College of Physicians and the American Academy of Family Physicians, state that patients older than 60 should begin treatment if their systolic blood pressure (top number) reaches 150. If the patient has high cardiovascular risk or a history of stroke, treatment should begin at 140.

The new recommendations come after a series of studies that show that a lower systolic blood pressure increases heart-health benefits for adults 60 and older, including reduced risk of heart attack and stroke. The Systolic Blood Pressure Intervention Trial (SPRINT) in 2015 found that targeting a blood pressure of 120 or lower was more effective to reduce the rates of major cardiovascular events than targeting 140.

“It’s difficult to draw absolute conclusions from these studies for a variety of reasons,” said Allen J. Taylor, MD, chief of Cardiology with MedStar Heart & Vascular Institute at MedStar Washington Hospital Center. “It’s important to remember that blood pressure doesn’t just measure pressure. It’s also a marker for other things going on in your body, such as stress, heredity factors, diet and exercise.” 

Dr. Taylor concluded that there’s no magic blood pressure number that applies to everyone. “Your health history and lifestyle greatly influence your heart health and what’s safe for you. Work with your doctor to monitor and effectively manage your blood pressure.”

The guidelines were published in the Annals of Internal Medicine and the Annals of Family Medicine.

About MedStar Washington Hospital Center:
MedStar Washington Hospital Center is a 926-bed, major teaching and research hospital. It is the largest private, not-for-profit hospital in the nation’s capital, among the 100 largest hospitals in the nation and a major referral center for treating the most complex cases. U.S.News & World Report consistently ranks the hospital’s cardiology and heart surgery program as one of the nation’s best. It also is a respected top facility in the areas of cancer, diabetes & endocrinology, Ear, Nose & Throat, gastroenterology & GI surgery, geriatrics, gynecology, nephrology, pulmonology and urology. It operates MedSTAR, a nationally-verified level I trauma center with a state-of-the-art fleet of helicopters and ambulances, and also operates the region’s only adult Burn Center.

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Women and Heart Disease: What you Need to Know

Eighty percent of all heart disease is preventable – and heart disease does affect women. In fact, it is the leading cause of death among women in the U.S. So it is very important for women of all ages to learn the facts about heart disease and know the symptoms, because there are steps you can take to reduce your risk and get treatment when you most need it.

What are the risk factors for heart disease?

Many different factors can put women at risk for developing heart disease.  Some things are out of your control. However, it is important to understand how the following risk factors contribute to your chances of developing heart disease:

  • Age - Research indicates that about 6 out of 100 women in their 40’s will develop coronary heart disease growing to nearly 1 out of 5 women in their 80’s.
  • Family History of Heart Disease - You are at greater risk if a close family member, a parent, brother, sister or grandparent developed heart disease before age 59.
  • Race – African–American women are at higher risk of developing heart disease as compared to women of other races.

Risk factors more under your control include:

  • Smoking – Smoking increases the risk of heart disease and stroke by 2 to 4 times and women who smoke have a 25 percent higher risk of developing heart disease than men who smoke.
  • Obesity - Excess body weight puts a strain on your heart, raising your blood pressure, LDL (bad) cholesterol and triglyceride levels, and lowering your HDL (good) cholesterol. Obesity also increases your risk for developing diabetes.
  • Diabetes- Adults with diabetes are two to four times more likely to have heart disease or a stroke than adults without the condition.
  • High Blood Pressure (HBP) - Elevated blood pressure makes the heart work harder. Chronic HBP scars and damages your arteries and can lead to heart attack, stroke, heart failure and
  • Lack of Physical Activity - A lack of physical activity comes with great risks as a sedentary lifestyle has been linked to an increased risk for blood clots, high blood pressure, heart attack, stroke and other heart related problems.
  • High Cholesterol - Cholesterol hardens over time into plaque which can narrow the artery walls and reduce blood flow leading to blood clots, heart attacks or strokes.

The ABCs of Women’s Heart Disease Symptoms

Heart disease symptoms can be different for women than men. They are sometimes subtler in nature and harder to identify. Because women tend to dismiss their symptoms as not significant, they are more likely to have a silent heart attack or die during their first heart attack.

The following is an ABC listing of heart disease symptoms to help guide you.

  • Angina:  pain, discomfort or fullness in the chest. (Women also report pain in the jaw, right arm or abdomen.)
  • Breathlessness: experienced during activities or waking up breathless at night
  • Blackouts: fainting
  • Chronic fatigue: an inability to complete routine activities and a constant feeling of tiredness
  • Dizziness: this can indicate irregular heartbeats, or arrhythmias
  • Edema: swelling, particularly of the lower legs and ankles
  • Fluttering heartbeats: palpations, rapid heartbeats that may cause pain or difficulty breathing
  • Gastric upset: nausea or vomiting, unrelated to diet, indigestion or abdominal pain

If you experience any of these symptoms frequently (about once a day), see a physician—the symptoms are serious and should not be ignored. Keep notes about when the symptoms occur, what triggers them, and what, if anything, relieves them. It is also helpful to make a list of past treatment and all medications you are currently taking.

How can I prevent heart disease?

There are steps you can take today to prevent heart disease. Here are some ways you can stay healthy:

  • Identify behaviors that contribute to your risk (smoking, unhealthy diet, lack of exercise)
  • Ask your physician about your numbers (blood pressure, cholesterol, glucose, body mass index or BMI
  • Learn about your family history
  • Discuss all of the above with your physician

We urge you to start on the road to become heart healthy today.  Learn more about heart disease.  Seek out guidance and support from medical professionals. Heart disease can be treated, prevented and even ended.

Have Any Questions?

We are here to help! Contact us for more information about heart health or to schedule an appointment. Call us at 202-877-3627.

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