Ensure Accurate Readings with In-Home Blood Pressure Monitors
The American Heart Association recommends that, if you have hypertension, you regularly monitor your blood pressure (BP) with a home monitor. Research shows people who use home monitors regularly tend to keep their blood pressure under control more effectively.
“Studies consistently show that readings taken at home are better indicators of risk, and, therefore, a better guide to the need for treatment, than are office readings. I encourage most of my patients to check their blood pressure at home,” says Samuel Mann, MD, professor of clinical medicine at Weill Cornell Medical College and author of the book, Hypertension and You (Rowman Littlefield, 2012).
WHAT YOU SHOULD KNOW
When choosing a blood pressure monitor, use a brand certified by the American Association of Medical Instrumentation, the British Hypertension Society, or the European Society for Hypertension. To find certified brands, visit the web site www.dableducational.org, click on “devices,” and then “recommended devices.”
Benefits of in-home readings
Taking BP measurements at home can help you determine whether or not you have “white coat hypertension,” which is when your BP is elevated at the doctor’s office but not elsewhere.
“Many patients and doctors wrongly believe that the ‘white coat’ phenomenon occurs only if you feel very nervous when a doctor is checking BP, but that is incorrect; it also may occur even if you do not feel nervous,” notes Dr. Mann. If you and your doctor discover that your BP is lower when measured at home, it can result in a reduction of medication and medication costs. Monitoring BP at home also means fewer visits to your doctor.
Ensuring accuracy
Many patients doubt the accuracy of in-home monitors themselves, but Dr. Mann says that the problem is usually not the monitors, but how they are used.
First, choose the right monitor. Dr. Mann says to use a monitor with an arm cuff, rather than a wrist or finger cuff, as these have been shown to be less reliable than arm cuffs.
Dr. Mann also recommends using an automatic, rather than a manual, monitor. “With a manual monitor, the act of pumping the bulb, deflating the cuff at the proper rate, listening for the sounds, and the effort involved can affect your BP while you are measuring it.”
Choose a reliable brand of monitor; Dr. Mann recommends the brand Omron for most of his patients. (See What You Should Know for more information on brands of monitors.) Check the accuracy of your monitor at your doctor’s office once every year or two.
Also, be sure you are using the correct size cuff; incorrect cuff size will produce inaccurate readings.
Check your BP in one arm, not both; most right-handed people find it easier to put the cuff on their left arm.
Do not check your BP immediately after putting on the cuff; Dr. Mann says this is perhaps the most frequent cause of misleadingly high home readings. “After you put on the cuff, sit for three to five minutes before you inflate it,” he advises.
How often and how many?
The number and timing of readings that you take also are important.
“Don’t take just one reading; take three readings, about one to two minutes apart,” says Dr. Mann. “After you take three readings, record them, and then take off the cuff.”
Check your BP no more than twice a week. “If a patient is checking her BP several times a day, it indicates that she is likely anxious about her BP, and this can affect the readings,” says Dr. Mann. However, if you have recently changed medications or have severe hypertension, follow your doctor’s orders, which may include checking it more frequently.
Take BP readings at random, ordinary times. “If you check your BP only when you think it is high—for example, when you are angry or upset—you will get higher BP readings, but these elevations are only temporary, and they are not representative or your usual BP,” notes Dr. Mann.
Gather information
Using a home BP monitor also can provide you with helpful information about what affects your BP.
“You can perform your own experiments and determine what elevates your BP and what doesn’t,” says Dr. Mann. For example, you can use your monitor to see if taking cold remedies or anti-inflammatory drugs, drinking coffee or other caffeinated beverages, getting vigorous physical exercise, or reducing the sodium in your diet raises or lowers your BP.
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