Check Your Blood Pressure at Home
Nearly half of all adults in the United States have hypertension—more commonly known as high blood pressure—according to the Centers for Disease Control and Prevention. However, only about one-quarter of these individuals have their blood pressure under control. You can achieve control through lifestyle interventions such as following a heart-healthy low-salt diet, limiting your alcohol intake, smoking cessation, and getting plenty of physical activity. Your doctor also may prescribe medications to help keep your blood pressure numbers where they should be. You can best keep an eye on those numbers by regularly checking your blood pressure at home— and if medical appointments make you anxious, the readings you get at home may be more accurate than those you get at your doctor’s office.
Advantages of Home Blood Pressure Monitoring
Mount Sinai cardiologist Bruce Darrow, MD, PhD, says that home blood pressure checks can help distinguish between true hypertension and “whitecoat hypertension,” a phenomenon in which blood pressure is higher when measured during a routine medical appointment than in other settings. Research has suggested that as many as one in five people may suffer from white-coat hypertension. “Some experts theorize that it is due to the anxiety many people experience when visiting the doctor’s office, and/or because they haven’t been given time to sit and relax for 10 minutes or so after what may have been a rushed, stressful journey to the office or clinic,” says Dr. Darrow.
Which Type of Blood Pressure Monitor is Best?
There is a wide range of home blood pressure monitors available online and at pharmacies. Dr. Darrow recommends you opt for one that meets American Medical Association criteria (see Resources) and takes your blood pressure using an arm cuff. “While monitors are available that take your blood pressure using a wrist cuff, studies have suggested that these are not as accurate as arm-cuff monitors,” he adds.
• Aneroid monitors, which have a cuff that is inflated by squeezing a rubber bulb, a dial gauge, and a stethoscope, are the most accurate type. But they can be difficult to use if your hand strength or hearing are compromised. “You need sufficient strength in your hands to be able to squeeze the bulb to properly inflate the cuff, and you also need to be able to hear your heartbeat properly through the stethoscope,” Dr. Darrow notes.
• Digital automatic monitors enable you to inflate the cuff by pressing a button, and your blood pressure reading shows up on a screen. “Most digital monitors save a record of your blood pressure over several months,” Dr. Darrow notes. “Some also will alert you if they detect an irregular heartbeat.”
• Public monitors You may have seen blood pressure monitors that are available for public use at many pharmacies. These generally are accurate if you follow American Heart Association (AHA) guidelines for checking blood pressure (covered in the next section). “However, they can be slightly stressful to use if you feel self-conscious about being observed by other people while taking your blood pressure, or feel like you have to hurry because someone else is waiting to use the machine,” Dr. Darrow observes. You may be better off investing in an inexpensive home monitor.
Follow the Guidelines
White-coat hypertension also may arise because your clinician isn’t following AHA guidelines when he or she checks your blood pressure. “As an example, chatting to you while taking a reading may affect the results and so can having you sit on the exam table with your feet dangling in the air instead of resting on a flat surface,” Dr. Darrow explains. It’s important that you follow the AHA guidelines yourself when taking your blood pressure at home.
• Avoid doing anything that might cause your blood pressure to spike in the 30 minutes before you measure it—this includes drinking coffee or other caffeinated beverages, smoking, exercising, and taking medications that raise blood pressure, such as nonsteroidal anti-inflammatory drugs like ibuprofen (Advil , Motrin ) and naproxen (Aleve , Naprosyn ).
• Go to the bathroom first, as having a full bladder can increase blood pressure.
• Sit in a comfortable chair with good back and arm support, and make sure that your feet are flat on the floor.
• Position the cuff on your bare upper arm (even a thin layer of clothing can cause a reading to be inaccurate) just above your elbow, and rest your arm on a table (ideally your upper arm should be level with your heart).
• Relax for about five minutes before inflating the cuff. Breathe steadily during the reading, and avoid moving or talking.
Keep Your Doctor Informed
Before you start checking your blood pressure at home it’s a good idea to make an appointment with your doctor so that he or she can ensure the cuff is the right size and that you are using the monitor correctly. “Your doctor also can compare the reading on your monitor to the reading on the monitor at his or her office to check that they are similar,” Dr. Darrow adds. “Be sure to ask your doctor what readings you should be expecting to see at home, and contact him or her if you notice any sudden increase.”
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