Monitoring Your Blood Pressure at Home

You can’t feel high blood pressure. Known as “the silent killer,” it can have devastating effects in your body but is undetectable without using a blood pressure measuring device.

High blood pressure affects approximately 30 percent of adults in the United States, and is a major risk factor for hearts attacks, heart failure, stroke and kidney disease.

So, Does This Mean We Should All Be Checking Our Blood Pressure Regularly?

The first step in detecting and controlling high blood pressure is to have it checked by a health professional during a physical exam, says Michelle Gordon-Canning, a former cardiology physician assistant with Sutter East Bay Medical Foundation. The American Heart Association recommends that blood pressure be checked starting at age 20 and every two years after that.

Blood pressure categories defined by the American Heart Association are:

• Normal:  <120/80
• Pre-hypertension:   120-139/80-90
• Stage 1 Hypertension:  140-159/90-99
• Stage 2 Hypertension:   160/100 or higher
• Hypertensive Crisis:    >180/110

“If you have already been diagnosed with high blood pressure or have had a heart attack, stroke, heart failure or kidney disease, maintaining strict control of your blood pressure can be lifesaving,” Gordon-Canning says. “In this situation, it is wise to routinely keep track of your blood pressure yourself, at home.”

Checking your blood pressure at home is also useful when your healthcare provider suspects that you have “white coat syndrome.” In white-coat hypertension, the anxiety of visiting the doctor can raise blood pressure. For these people, Gordon-Canning says, measuring blood pressure outside of a doctor’s office, in a calm, relaxing environment, can provide a more accurate reading.

Blood pressure machines available in public places like drug stores are convenient, but may not be totally accurate, Gordon-Channing notes. If you use a public blood pressure machine and receive a high result (over 120/80), be sure to see your doctor to have this reading verified.

If you have decided to monitor your blood pressure at home, follow these tips:

• Purchase a reliable blood pressure monitor, one with a cuff that wraps around your upper arm. The cuff should fit you well - it shouldn’t fit loosely, and shouldn’t be too tight when not in use. Wrist and finger monitors are not recommended because the readings are less reliable.
• When choosing the type of blood pressure monitor, be sure that it has been validated for accuracy and reliability. This information can be found at: dableducational.org. Your healthcare provider may also have good recommendations.
• Once you have a home monitor, bring it in to your healthcare provider to ensure you know how to use it correctly and to verify the accuracy of the monitor.
• Before you take your blood pressure, be sure to sit quietly for five minutes, with your arm relaxed on a supported surface at the level of your heart.
• Your back should be supported and both feet should be flat on the floor.
• The cuff should be positioned on your upper arm as described in the instructions that came with your monitor. It is easier to use your non-dominant arm (if you are right-handed, use your left arm).
• Avoid caffeine, smoking, or exercising at least 30 minutes before taking your blood pressure. Do not take a reading if you are stressed or angry.
• Measure your blood pressure at the same time each day – preferably first thing in the morning before taking your medications, or as directed by your healthcare provider.

Blood Pressure Too High?

Gordon-Canning suggests you repeat the measurement five minutes later, and take the measurement on both arms. She does NOT recommend more frequent measurements, one after the other. “This behavior can increase your anxiety, which will raise your blood pressure more,” says Gordon-Canning.

Be sure to see your healthcare provider if you are consistently having high blood pressure readings at home.