How to Get Accurate Blood Pressure Readings

More than 100 million Americans have hypertension (HT), and almost half a million deaths annually include HT as a primary or contributing cause, according to the Centers for Disease Control and Prevention (CDC).

An often neglected, but very important, factor in the management of HT is making sure your blood pressure (BP) readings are accurate, says Weill Cornell hypertension expert Samuel Mann, MD. “Several factors commonly contribute to getting inaccurate, misleadingly high BP readings, both in the doctor’s office and at home, which can result in overtreatment.”

The Right Way to Measure BP

Getting an accurate measurement of your BP is key to appropriate treatment.

“Whether you are at home or in a doctor’s office, you need to sit for five minutes before your BP is taken to get an accurate reading,” says Dr. Mann.

According to Dr. Mann, the correct way to take your blood pressure at home is to put on the arm cuff, sit for five minutes, and then take three readings, waiting about one minute between readings. Then, drop the first reading and obtain the average of the second and third readings. He recommends using an arm cuff rather than a wrist cuff. If you’re wondering what brand of BP monitor to get, Dr. Mann recommends Omron as a reliable brand.

How often do you need to check your BP at home?

“I strongly discourage patients from checking their BP multiple times a day. The excessive focus on BP often results in misleadingly elevated readings,” advises Dr. Mann. “Check it once a day for a few days if it’s high or if you have just started taking a medication or had changes in your medication regimen.

“If you have well-controlled HT, checking your BP two or three times a week is sufficient. Also, vary the time of day you take readings to sample different times.”

More on Measurements

Keep a written record of your BP readings, and take it to your doctor’s appointments. This will let your doctor see how you are responding to treatment and whether any changes are needed.

Dr. Mann also cautions, “Don’t get excited about an ‘outlier’—a reading that is much different than the rest of your readings. It’s not uncommon to have one of these occasionally—it isn’t a cause for alarm.”

Also make sure your reading is done correctly when you’re at a doctor’s appointment. If your BP is taken without first sitting quietly for five minutes and it is elevated, ask the nurse or doctor if he or she can recheck it after you sit for several more minutes. And if you’re not told what your reading is, ask: It’s important for you to know your numbers.

Lower BP with Lifestyle

For some patients with mild hypertension, adopting a healthier lifestyle can lower blood pressure enough to eliminate the need for medication.

“If you already take medication for HT, making lifestyle changes may allow you to reduce the number and/or dosage of medications you take,” says Dr. Mann, who is the author of the book, Hypertension and You. Lifestyle factors that can have the most beneficial effects on BP are diet, sodium restriction, exercise, and weight loss for people who are overweight or obese. “One step to a healthier diet is going easy on the carbs,” says Dr. Mann.

Many Americans’ diets are high in simple carbohydrates and low in vegetables and fruit. An easy way to improve your diet is to simply swap fruits and vegetables for high-carb items like bread, pasta, chips, and crackers. When you do eat high-carb foods, choose whole grains and legumes (beans, peas, and lentils) and skip the snack foods, baked goods, and other packaged, processed products. And don’t forget about sugary drinks, including teas, coffees, and energy drinks as well as regular soft drinks; they’re loaded with carbs and calories.

“Obesity is a very important contributing factor to HT,” advises Dr. Mann. “If you are overweight, losing weight can bring down your BP enough so that you don’t have to take medication. For many patients, a healthy diet by itself, and more so if it leads to losing 10, 20, or 30 pounds, will make a difference.”

If you’ve been unsuccessful in previous attempts to lose weight, ask your doctor for a referral to a nutritionist or a health-care provider who specializes in weight loss.

Getting regular exercise also can help reduce your BP. Research has shown that doing 20 to 30 minutes of aerobic exercise three or more days each week may lower your BP by as much as 9 mmHg. Aerobic activities, which require continuous movement of your major muscle groups, include brisk walking, jogging, cycling, swimming, and dancing. Dr. Mann says the type of activity you choose isn’t that important: “The best exercise is the one you like enough to do.”

Salt Matters for Some People

It’s frequently recommended that people with HT reduce the amount of salt (sodium) they consume, but salt is not the issue for all people. Dr. Mann says that, among younger people with HT, half or more of African Americans and 25 percent of Caucasians have salt-sensitive HT, which means that the more salt they eat, the higher their BP readings. Importantly, the percentage with saltsensitive HT increases with age.

“To cut your salt consumption, avoid restaurant and takeout foods, which tend to be very high in sodium; the salt you get from a salt shaker is only a small part of your total intake,” says Dr. Mann.

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