Blood Pressure Monitoring at Home: Why, When and How?

High blood pressure, or hypertension, is a disease which affects over 1.3 billion people across the world. It is a significant risk factor for various cardiovascular diseases and other health complications. Regular monitoring of blood pressure is crucial for detecting changes early and taking appropriate actions.

In this post, we’ll explore the insights from several reputable sources to provide you with a comprehensive guide to blood pressure monitoring at home and answer the most popular questions about blood pressure monitoring.

1. Understanding blood pressure readings

The American Heart Association [1] emphasizes the importance of comprehending blood pressure measurement to manage your cardiovascular health effectively. Blood pressure is typically expressed as two numbers: systolic blood pressure (the higher number) and diastolic blood pressure (the lower number). Systolic blood pressure represents the force exerted on artery walls when the heart beats, while diastolic blood pressure signifies the pressure when the heart rests between beats.

The following ranges are suggested by the American Heart Association to interpret blood pressure readings:

- Normal: Systolic < 120 mm Hg and Diastolic < 80 mm Hg

- Elevated: Systolic 120–129 mm Hg and Diastolic < 80 mm Hg

- Hypertension Stage 1: Systolic 130–139 mm Hg or Diastolic 80–89 mm Hg

- Hypertension Stage 2: Systolic ≥ 140 mm Hg or Diastolic ≥ 90 mm Hg

- Hypertensive Crisis: Systolic > 180 mm Hg and/or Diastolic > 120 mm Hg

2. Monitoring blood pressure at home

The Mayo Clinic provides valuable insights into monitoring blood pressure at home. Home monitoring offers several benefits, including:

a. Increased accuracy: Blood pressure readings can be affected by factors like stress, caffeine, and the “white coat effect” (elevated readings due to doctor’s office anxiety). Home monitoring provides a more accurate representation of your everyday blood pressure

b. Early detection: Regular monitoring allows you to detect any deviations from your baseline readings early, enabling prompt medical intervention if necessary.

c. Personal empowerment: Taking an active role in monitoring your blood pressure empowers you to make informed lifestyle choices that positively impact your heart health.

3. Why is home blood pressure monitoring important?

Regular blood pressure monitoring at home is important because it can help you to:

• Identify high blood pressure early on, before it causes any damage to your health.
• Track your blood pressure over time to see how it is responding to treatment.
• Make sure that your treatment is working and that your blood pressure is under control.
• Detect any changes in your blood pressure that may need to be addressed.
• Help your doctor make decisions about your treatment.

Home blood pressure monitoring is the best way to track your blood pressure over time. It is also more convenient than going to the doctor’s office to have your blood pressure taken.

4. What are the guidelines for accurate blood pressure readings?

- Choose a validated home blood pressure monitor.

- Measure at the same time each day.

- Rest for at least 5 minutes before measuring.

- Sit with your back straight and feet flat on the floor.

- Avoid talking during the measurement.

- Take multiple readings and calculate the average.

5. How to Perform Home Blood Pressure Monitoring?

The American Academy of Family Physicians [2] outlines simple steps for effective home blood pressure monitoring:

a. Prepare: Relax for a few minutes before measuring. Avoid caffeine, smoking, and exercise for 30 minutes prior.

b. Position: Sit correctly with your arm supported and your back straight.

c. Cuff Placement: Place the cuff on your bare upper arm, just above the elbow, with the bottom edge an inch above your elbow crease.

d. Measurement: Follow the monitor’s instructions to initiate the measurement. Remain still and quiet during the process.

e. Recording: Record the date, time, and readings in a log. Share this log with your healthcare provider during visits.

6. How do digital blood pressure monitors work?

Digital monitors are more popular for measuring blood pressure. They often are easier to use than aneroid units. The digital monitor has a gauge and stethoscope in one unit. It also has an error indicator. The blood pressure reading displays on a small screen. This may be easier to read than a dial. Some units even have a paper printout that gives you a record of the reading.

Inflation of the cuff is either automatic or manual, depending on the model. Deflation is automatic. Digital monitors are good for hearing-impaired patients, since there is no need to listen to your heartbeat through the stethoscope.

7. How to use a blood pressure monitor?

There are many different types of blood pressure monitors available, so you can choose one that fits your needs and budget.

When you are choosing a blood pressure monitor, look for one that has been validated by the American Heart Association or the Association for the Advancement of Medical Instrumentation. These organizations have tested the monitors to make sure that they are accurate. If you live outside of the United States find out which government organization validates blood pressure monitors in your country and use the one from the approved list.

Preferably buy a blood pressure monitor with a Bluetooth connection which allows you to link it with an iPhone or an Android phone and send your data directly to a blood pressure tracker app.

Here are the steps on how to use a blood pressure monitor:

1. Sit in a comfortable chair with your feet flat on the floor.
2. Relax for five minutes before you take your blood pressure.
3. Wrap the blood pressure cuff around your upper arm, making sure that it is snug but not too tight.
4. Press the start button on the blood pressure monitor.
5. The monitor will inflate the cuff and then release it.
6. The monitor will display your blood pressure readings.

Take your blood pressure twice a day, once in the morning and once in the evening. Write down your readings each time so that you can track them over time. Alternatively save them in a blood pressure log app.

8. What are the tips for getting accurate blood pressure readings?

• Use the same blood pressure monitor every time you take your blood pressure.
• Take your blood pressure at the same time each day.
• Don’t talk or move while you are taking your blood pressure.
• If you are taking medication for high blood pressure, take it as prescribed by your doctor.
• Take multiple readings and record the results. Each time you measure, take two readings one minute apart and record the results using a blood pressure tracker.

If you follow these tips, you can be sure that you are getting accurate blood pressure readings. This will help you to manage your blood pressure and reduce your risk of developing serious health problems.

9. How to interpret your blood pressure readings and act on them?

Interpreting your blood pressure readings is essential for taking appropriate actions. If your readings consistently fall within the normal range, maintain a heart-healthy lifestyle to prevent hypertension. Elevated or high readings should prompt you to:

a. Consult Your Doctor: Share your home blood pressure log with your healthcare provider for analysis and guidance.

b. Lifestyle Modifications: Embrace a balanced diet, exercise regularly, manage stress, limit sodium intake, and avoid tobacco and excessive alcohol.

c. Medication Adherence: If prescribed medication, take it as directed and attend follow-up appointments.

10. What to do If you get a high blood pressure reading?

• If your blood pressure is higher than 180/120 and you are experiencing signs of possible organ damage such as chest pain, shortness of breath, back pain, numbness/weakness, change in vision or difficulty speaking, do not wait to see whether your pressure comes down on its own. Immediately call for medical assistance.
• A single high reading is not an immediate cause for alarm. If you get a reading that is slightly or moderately higher than normal, take your blood pressure a second time and write the results of the two measurements down. Consult your health care professional to verify if there’s a health concern or whether there may be any issues with your monitor.
• If your blood pressure readings suddenly exceed 180/120 mm Hg, wait five minutes and test again. If your readings are still unusually high, contact your health care professional immediately.

11. Who benefits most from home blood pressure monitoring?

• Anyone diagnosed with high blood pressure
• Individuals starting high blood pressure treatment to determine its effectiveness.
• Individuals with risk factors for high blood pressure.
• Pregnant women experiencing pregnancy-induced hypertension.
• People who only have high readings at the health care professional’s office (“white coat” hypertension).
• People who only have high readings at home but not at the health care professional’s office (“masked” hypertension).

12. Which factors can affect blood pressure readings?

In addition to the tips mentioned above, there are other factors that can affect blood pressure readings. These include:

• Stress
• Caffeine
• Alcohol
• Smoking
• Exercise
• Medications
• Illness

13. Left-arm versus right-arm blood pressure?

Several studies have been done to determine what is a normal variation between right and left arm. In general, any difference of 10 mm Hg or less is considered normal and is not a cause for concern.

14. How do I know if my monitor is accurate or if I am using it correctly?

Once you buy your device, have your doctor check it for accuracy. They should check your monitor once a year. On your own, periodically check the tubing for cracks and leaks. Proper care and storage are necessary. Make sure the tubing is not twisted when you store it. Keep it away from heat.

Ask your doctor or nurse to teach you how to use your blood pressure monitor correctly. This will help you achieve good results in controlling your blood pressure.

15. What do these popular blood pressure medical terms mean?

• Blood pressure: The force of blood against the walls of the artery.
• Hypertension: High blood pressure.
• Hypotension: Low blood pressure. This occurs when your systolic pressure is consistently below 90 or is 25 points below your normal reading.
• Brachial artery: A blood vessel that goes from your shoulder to below your elbow. You measure your blood pressure in this artery.
• Systolic blood pressure: The highest pressure in an artery when your heart is pumping blood to your body.
• Diastolic bllod pressure: The lowest pressure in an artery when your heart is at rest.

16. Why keep a blood pressure journal?

One blood pressure measurement is like a snapshot. It only tells what your blood pressure is at that moment. A record of readings taken over time provides a “time-lapse” picture of your blood pressure that can help your doctor to ensure that your treatment is working.

It is more convenient to store your blood pressure readings in a mobile app (rather than writing them in a paper journal). Most blood pressure tracker apps will provide graphs with insights and let you share data with your doctor remotely. Try a free blood pressure tracker in the blood pressure app BreathNow which also includes a heart rate monitor, stress monitor and a set of slow breathing exercises to lower anxiety and high blood pressure without medications.

Please note that as of August 2023 there are no mobile apps which can measure blood pressure without an external blood pressure monitor. Currently you can not take blood pressure readings with an Apple Watch either. If you want the blood pressure readings from your blood pressure monitor to be transferred to your blood pressure app automatically, invest in the monitor with a Bluetooth connection.

17. Questions to ask your doctor about blood pressure monitoring?

• Why do I need to monitor my blood pressure at home?
• How often do I need to measure my blood pressure?
• What type of monitor should I use?
• What do my blood pressure readings mean?
• What is considered a normal blood pressure for me?
• What should I do if my readings are abnormal?
• Are there any lifestyle changes I can make to help manage my blood pressure?
• Do I need to take medicine to manage my blood pressure?
• What other things can affect a blood pressure reading?

Conclusion

1. Regular blood pressure monitoring at home is a proactive step towards safeguarding your cardiovascular health.
2. By taking control of your blood pressure, you empower yourself to make informed choices that contribute to a healthier, happier life.
3. Blood pressure tracker apps will remind you about taking a reading, show insights which help to manage blood pressure and share the data with your doctor without you leaving your home.

References:

1. American Heart Association: Blood Pressure Monitoring:
2. Blood pressure monitoring at home, familydoctor.org,
3. Get The Most Out of Home Blood Pressure Monitoring, Mayo Clinic