How To Accurately Measure Blood Pressure At Home
High blood pressure is one of the top risk factors for heart attack and stroke. It’s also common among people who develop severe COVID-19 symptoms.
So, with more people at home practicing social distancing and with fewer chances to check blood pressure at public pharmacy machines or doctor visits, it’s more important than ever to know how to do it at home.
How do I select a home blood pressure monitor?
“The readings you get at home are really important, because they reflect the pressure your heart is facing on a day-to-day basis,” said Dr. Michael Hochman, a doctor of internal medicine at Keck Medicine of the University of Southern California.
A list of validated home monitors, the first in the United States and commissioned to meet the American Medical Association’s criteria, is available at validateBP.org. The Advancement of Medical Instrumentation, the British Hypertension Society and the European Society of Hypertension also certify devices.
The device should measure blood pressure on the upper arm, which produce a more reliable result than those that measure from the wrist.
Many devices are automated. Simply put on the cuff and press a button. The results are displayed digitally.
Some will store readings, calculate an average blood pressure over time, or even transmit them to your doctor.
Your health care provider should check the device about once a year to ensure its accuracy.
How do I get the most accurate measurement?
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Because blood pressure tests are so important, and sometimes uncomfortable, they can be stressful. That is a problem because anxiety and nerves while taking these tests can raise your reading so that it is not an accurate indicator of your true heart health.
This fear of having your blood pressure checked may be caused by another factor, white coat syndrome or white coat hypertension as defined by the Mayo Clinic. This is when people in clinical situations, such as a clinic or doctors office, can experience stress from the surrounding environment. Environmental stress in turn can cause a spike in blood pressure, which can cause falsely inflate readings.
There are ways to relax during a home or even in-office blood pressure test so you can get a good reading.
Buying A Blood Pressure Instrument To Measure Your Blood Pressure At Home
Blood pressure instruments can be purchased in most pharmacies. Buy a blood pressure instrument that has been approved by the Association for the Advancement in Medical Instrumentation , the British Hypertension Society or the International Protocol . These labels will be marked clearly on the box. If you are unsure whether an instrument is approved, ask your pharmacist for help. Once you have bought the instrument, ask your doctor or pharmacist to check it to make sure the instrument measures your blood pressure accurately.
What Does My Blood Pressure Reading Mean
Normal blood pressure is 120/80 or lower. High blood pressure is 140/90 or higher. If your blood pressure is between 120/80 and 140/90, you may have something called prehypertension. This means that you are at risk for high blood pressure.
|High blood pressure: Stage 2||160 or higher||100 or over|
*If you have diabetes or kidney disease, high blood pressure ranges may be lower than for other people. Or, if you are older than 65, goal blood pressure may be higher. Talk to your doctor about what is considered high blood pressure for you.
Blood Pressure Monitoring At Home
Many people monitor their blood pressure at home. They often do this to manage or treat a certain health condition. If you monitor your blood pressure at home, keep a record, or log, of the measurements. The record shows your doctor how your blood pressure changes throughout the day. If you take medicines to control your blood pressure, it will help document if they are working. Measuring your blood pressure at home is a good way to take part in managing your health.
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How Blood Pressure Medications Work
Blood pressure tends to vary during the day. It tends to be higher when you wake up in the morning and during the morning hours, and lower in the night and when sleeping. However, there are people whose blood pressure does not drop at night researchers call these “non-dippers.”
Most blood pressure medications have been designed for ease of use, meaning they are meant to be taken once per day. Even so, these medications are not equally effective over the entire 24-hour period during which they are active.
The action of blood pressure drugs peaks anywhere from four to 15 hours later after you take a dose. Ideally, the drug is prescribed so that the peak concentration coincides with the time of day when your blood pressure is at its highest.
There are several different types of blood pressure medications that have different mechanisms of action and are thus best taken at certain times of day.
Medications that are best taken in the morning:
- Diuretics, or water-pills”:These include Diuril and Lozol , and work by helping your kidneys get rid of extra water in your body. Because diuretics can cause you to urinate more , it’s best to take them in the morning. If you need a second dose, take it by mid-afternoon.
Some other common blood pressure medications that are best taken at bedtime include:
- ACE inhibitors , including Lotensin and Vasotec
- ARBs , such as Avapro
- Beta blockers, such as Lopressor
- Calcium Channel blockers, such as Norvasc
How Do I Measure My Blood Pressure
Before you check your blood pressure, you should:
- Wait 30 minutes after eating or using caffeine, alcohol, or tobacco products.
- Go to the bathroom and empty your bladder.
- Rest for 3 to 5 minutes and do not talk.
- Sit in a comfortable position, with your legs and ankles uncrossed and your back supported.
- Elevate your left arm to the level of your heart. Place it on a table or desk and sit still.
- Wrap the cuff around the upper part of your bare arm. The cuff should be smooth and snug. There should be enough room for you to slip one fingertip under the cuff.
- Check the placement of the cuff. The bottom edge of it should be 1 inch above the crease of your elbow.
Below are the steps to take to use an aneroid monitor.
Below are the steps to take to use a digital monitor.
- Turn the power on to start the unit.
- On the automatic models, the cuff will inflate by itself with a push of a button. On the manual models, you have to inflate the cuff. You do this by squeezing the rubber bulb at a rapid rate.
- After the cuff inflates, the automatic device will slowly let air out.
- Look at the display screen to get your blood pressure reading. It will show your systolic and diastolic pressures. Write down the measurement in your record. The systolic pressure goes in front of the diastolic pressure. For example, 120/80.
- Press the exhaust button to release all of the air from the cuff.
- If you need to repeat the measurement, wait 2 to 3 minutes before starting.
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Avoid Common Errors While Taking Multiple Readings In A Row
Avoid these common errors 5 while resting in between measurements:
- Checking the latest stock market prices.
- Reading or watching the news.
- Getting out of your chair to do a task quickly.
- Changing your body position like crossing your legs or slouching.
- Taking a quick drink or snacking on some food close by.
- Anything other than sitting quietly and remaining relaxed.
In addition to those activities to avoid, prior to starting the first reading make sure to do the following 6:
- Dont exercise within 30 minutes.
- Dont eat or drink within 30 minutes.
- Avoid all caffeine 30 minutes prior to measuring.
- Dont smoke 30 minutes prior.
- Empty your bladder prior to measuring your blood pressure or make sure youre not experiencing the urge to use the bathroom.
- Wear comfortable clothes including short sleeve shirts.
- Sit in an upright chair with your back resting against the chair.
- Keep your feet flat on the floor and dont cross your legs.
- Wrap the cuff around your bare skin and not over clothing, including thin material.
- Maintain your arm in the correct position and the cuff at heart level.
If theres any doubt about how to position your arm 7 or to achieve heart level, please refer to my blog post and refresh yourself on these two crucial details, Effect of Arm Position on Blood Pressure.
How Do I Make Sure I Am Taking A Good Reading
Now that weve gotten the background information out of the way, its time to get started!
- Sit with your back straight, your legs uncrossed, and your feet flat on the floor.
- Place the cuff on your left arm or wrist .
- For upper arm monitors, wrap the cuff around the middle of your bare upper arm, about ½ above the elbow. It should be fastened snugly, but you should be able to slide two fingers underneath the cuff. Place the air hose on the inside of the arm near the crook of your elbow so that the artery position mark is aligned with your brachial artery.
- For wrist monitors, with the palm facing upwards, attach the monitor to the inside of your wrist. Fasten securely with the top edge of the cuff aligned with the crease of your wrist.
Thats all there is to it!
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Measuring Ambulatory Blood Pressure
High blood pressure can also be diagnosed through a special device called an ambulatory blood pressure monitor. A doctor, nurse or pharmacist will get you to wear the device for a full day. The device measures blood pressure every 20 to 30 minutes and gives the doctor an average of your blood pressures during the day and while you are sleeping. These devices are not available everywhere and can be uncomfortable to wear.
If You Get A High Blood Pressure Reading
- 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 few more times and consult your healthcare 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 doctor immediately. You could be experiencing a hypertensive crisis.
- If your blood pressure is higher than 180/120 mm Hg and you are experiencing signs of possible organ damage such as chest pain, shortness of breath, back pain, numbness/weakness, change in vision, difficulty speaking, do not wait to see if your pressure comes down on its own. Call 911.
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What Does Your Blood Pressure Reading Mean
If this is your first time taking your blood pressure, discuss the results with your doctor. Blood pressure is a very individualized vital sign reading, which means it can be very different for each person. Some people have naturally low blood pressure all the time, for example, while others may run on the higher side.
In general, a normal blood pressure is considered anything less than 120/80. Your own personal blood pressure will depend on your gender, age, weight, and any medical conditions you have. If you do register a blood pressure reading of 120/80 or over, wait two to five minutes and recheck.
If its still high, talk to your doctor to rule out hypertension. If your blood pressure ever goes over 180 systolic or over 120 diastolic after a repeat reading, seek emergency medical care right away.
Take A Blood Pressure Reading On Samsung Galaxy Watch
Once that calibration process above is completed, you can go to the Samsung Health Monitor app on your watch or use the dedicated widget to take a measurement.
It will take 30 seconds to take a measurement, and much like taking an on the spot heart rate measurement, you should ideally be sitting down, relaxed, with your arm on a flat surface like a table and the watch sat snug on your wrist. This will ensure you get a more accurate reading.
Samsung also suggests that you conduct the calibration process every four weeks to ensure you’re getting the most reliable blood pressure data recorded in the Health Monitor app
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Taking Multiple Blood Pressure Readings In A Row
Many people monitoring their blood pressure at home take one reading and puts the machine away. Others, will take multiple readings in a row and obtain different results. I get asked this question many times and want to give you the answer to the question. Can I take multiple blood pressure readings in a row?
You can take multiple blood pressure readings in a row. The American Heart Association recommends taking 2-3 measurements about one minute apart. Two to three readings will minimize random errors and provide more accuracy for estimation of blood pressure.
Keep reading, and Ill explain to you in complete detail how to perform this sequence as accurately as possible. Its crucial to monitor and record accurate readings for your blood pressure maintenance and program. Inaccurate measurements can play tricks on your mind and make it more difficult on your doctors diagnosis and treatment.
BP Tip: Did you know you can lower BP naturally by changing how you breathe a few times a day? Theres a device approved by the FDA and The American Heart Association gave it the thumbs up. It simply guides your breathing for you a few minutes a day which has been proven to lower blood pressure. You can check it out in the manufacturers website by .
Recommended Reading: Side Effects Of Hypertension
Blood Pressure Assessment Tips
Keep learning about blood pressure assessment by reading how to mitigate NIBP and auscultating innacuracies by watching the plethysmography waveform on your pulse oximeter and noting the mean arterial pressure.
Read next: Learn how to read a MAP.
1. James PA, Oparil S, Carter BL, et al. 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report From the Panel Members Appointed to the Eighth Joint National Committee . JAMA. 2014 311:507-520.
2. Pickering TG, Hall JE, Appel LJ, et al. AHA Scientific Statement: Recommendations for blood pressure measurement in humans and experimental animals, part 1: blood pressure measurement in humans. Hypertension. 2005 45: 142-161.
3. Deakin CD, Low JL. Accuracy of the advanced trauma life support guidelines for predicting systolic blood pressure using carotid, femoral, and radial pulses: observational study. BMJ. 2000 321: 673674.
4. Lehman LH, Saeed M, Talmor D, Mark R, Malhotra A. Methods of blood pressure measurement in the ICU. Crit Care Med. 2013 41:34-40.
This article, originally posted Apr. 9, 2014, has been updated.
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One sheet: Common blood pressure reading mistakes
What Affects A Blood Pressure Reading
Many things can affect a blood pressure reading, including:
- Nervousness about having your blood pressure taken. This is called white coat syndrome. As many as 1 in 3 people who have a high blood pressure reading at the doctors office may have normal blood pressure readings outside of it.1
- What you ate, drank, or did before your reading. If you smoked, drank alcohol or caffeine, or exercised within 30 minutes of having your blood pressure measured, your reading might be higher.2
- How you are sitting. Crossing your legs and letting your arm droop at your side rather than rest on a table at chest height can make your blood pressure go up.2
Its important to get an accurate blood pressure reading so that you have a clearer picture of your risk for heart disease and stroke.
A reading that says your blood pressure is lower than it actually is may give you a false sense of security about your health. A reading that says your blood pressure is higher than it actually is may lead to treatment you dont need.
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