Have you been diagnosed recently with hypertension or high blood pressure? If so, your doctor may have explained the importance of monitoring your blood pressure at home and that it is a vital part of managing your blood pressure. If you’ve made the decision to monitor your blood pressure at home, then congratulations! You’ve just taken a significant step toward taking control of your health.
The American Heart Association (AHA) recommends daily home monitoring for all people with high blood pressure to help doctors determine whether treatments are working. Your daily monitoring sheet is an important tool that physicians use to see your progress in treatment and if other steps are needed to reach your end goal of managing your blood pressure.
Home blood pressure monitors or blood pressure apparatus are available widely and can be purchased even without a prescription. But not all blood pressure monitors are created equal, hence it’s important to know how to find a good home blood pressure monitor and of course know how to use it correctly.
Now that we’ve introduced blood pressure monitoring at home as part of the management of hypertension, some questions remain. What is the importance of daily home monitoring? What is the best way to do this? How do I know if my blood pressure apparatus is good enough? How do I use it correctly? When you should check your blood pressure? How often do I check it and what may affect the results? These are all good questions Read on to find out the answers.
WHY DO I NEED TO MONITOR MY BLOOD PRESSURE AT HOME?
Monitoring your blood pressure at home has the following advantages:
- Early diagnosis. As opposed to occasional blood pressure readings in the clinic, self-monitoring at home can give you a more accurate picture of your usual or average blood pressure reading. This in turn can help your doctor diagnose high blood pressure early.
- Treatment monitoring. How do you know if your medications and lifestyle changes are working? Monitoring your blood pressure at home regularly is the only way to answer that question. Any decisions made by your doctor about your treatment, such as dose adjustments or changes in medications are based on any blood pressure changes seen on your blood pressure monitoring so the importance of regular blood pressure monitoring cannot be emphasized enough.
- Motivate you to take control. Self-monitoring encourages you have a stronger sense of control over your own health. It might also help you feel more driven and determined to control your blood pressure with lifestyle changes (improved diet and physical activity) coupled with proper medication use.
- Reduce your health care expenses. By vigilantly monitoring your blood pressure at home, it might cut down on clinic visits.
- Verify if your blood pressure is consistent with that in clinical settings. Some people experience sudden and unusual rise in their blood pressure during clinic visits which may be attributed to nervousness, a condition called, white coat hypertension. While other people may have a normal blood pressure at a clinic but have a higher blood pressure elsewhere, known as masked hypertension. By monitoring blood pressure at home regularly can help determine if you truly have high blood pressure.
NOTE: There are cases where it is not advisable to monitor your blood pressure at home. Patients with irregular heartbeats may not be able to rely on blood pressure monitors as it might not give an accurate reading. In cases like this, it is best to speak to your doctor for a more targeted approach to monitoring your blood pressure.
TYPES OF HOME MONITORS: HOW TO CHOOSE THE BEST ONE FOR YOU
These days, most home blood pressure monitors are readily available in pharmacies and medical supply stores, some even sell them online. Most experts agree that the manual type of BP monitor is still the best way to confirm a diagnosis if hypertension but for daily monitoring, if a manual type is unavailable, then the most reliable (as per American Heart Association) is an automatic/digital, cuff-style, bicep (upper-arm) monitor. You may also ask your physician to help you pick the monitor that’s best for you.
There are some patients however, that have very large arms that may not fit into the arm cuff of most monitors, in cases like these, measuring blood pressure at the wrist or lower arm may be acceptable if the monitor is correctly and if BP measurements are checked against those taken in your doctor’s office. Meanwhile, for patients who have no blood pressure monitors at home, they may opt to go to pharmacies or stores who offer free public use of blood pressure devices. However, please take note that the accuracy of these devices may vary.
When choosing a blood pressure monitor, here are some features to consider:
- Cuff size. It is very important to have a blood pressure monitor that fits perfectly on your arm. Ill-fitting cuffs won’t give you accurate blood pressure measurements. When in doubt, seek the advice of your doctor on what cuff size you need.
- Monitor display. The display screen on your BP monitor shows your blood pressure measurements, therefore it should be clear and readable.
- Cost. There are numerous BP monitors in the market these days. Some are more expensive than others. Try to buy one that’s in your budget BUT is still reliable.
TIP: To check for the accuracy of your BP monitor, you can bring it, at least once a year, to your doctor’s clinic and compare your monitor’s readings with those taken at the clinic. Also have your doctor watch you use the device to see if you’re doing it correctly.
UNDERSTANDING BLOOD PRESSURE READINGS
Blood pressure measurements are noted down as two distinct numbers. They are the systolic (top) number and diastolic (bottom) number. The systolic blood pressure, measures the pressure in your arteries when your heart beats, while the diastolic blood pressure, measures the pressure in your arteries when your heart rests between beats. This is measured in millimeters of mercury (mmHg). Therefore, a blood pressure of 120/80 mm Hg is read as “120 over 80.”
According to the American Heart Association, these are the blood pressure categories:
- Normal: Readings of less than 120 mm Hg systolic and 80 mm Hg diastolic (less than 120/80 mm Hg)
- Elevated: Readings that consistently range from 120 to 129 mm Hg systolic and less than 80 mm Hg diastolic
- High blood pressure stage 1: Readings that consistently range from 130 to 139 mm Hg systolic or 80 to 89 mm Hg diastolic
- High blood pressure stage 2: Readings consistently at 140 mm Hg systolic or 90 mm Hg diastolic or higher.
HOW CAN I GET AN ACCURATE BLOOD PRESSURE READING?
So now that we know the importance of taking our blood pressure, how to choose the best device as well as the basics of blood pressure reading, it’s time to know some best practices for getting an accurate blood pressure reading:
- Measure your blood pressure at least twice daily. Take it first in the morning BEFORE eating breakfast or taking any medications but DO NOT take your blood pressure upon waking up. Blood pressure readings are often a little higher in the morning, especially when taken right after you wake up, giving you an inaccurate reading. If you exercise after waking, take your blood pressure BEFORE exercising. Take the second measurement in the evening. It is recommended that you take your blood pressure at the same times each day. If your device keeps track of heart rates, write them down as well. Record every reading you take.
- Take a repeat blood pressure reading. To verify its accuracy, take two or three readings each time with a 3-minute interval to make sure your results are the same.
- Avoid food, caffeine, tobacco and alcohol for 30 minutes before taking a reading. Another thing to remember is to empty your bladder first. A full bladder can increase blood pressure slightly.
- Make sure you’re in a warm and comfortable room. In cold temperatures, your heart will be working twice as hard to keep you warm. This in turn, may give you an elevated blood pressure reading. So, get to a comfortable temperature before measuring.
- Sit correctly. Take time to sit quietly before and during monitoring. Before taking your blood pressure, sit for five minutes in a comfortable position with your feet flat on the floor and your legs and ankles uncrossed. Your back should be supported against a chair. Try to be calm and not think about stressful things. It’s also important not to talk while taking your blood pressure.
- Make sure your arm is in the correct position. Rest your arm, raised to the level of your heart, on a table, desk or chair arm. To achieve this, you may need to place a pillow or cushion under your arm to raise it high enough. Make sure the bottom of the cuff is placed directly above the bend of the elbow. Also, remember to always use the same arm when taking your blood pressure.
- Wrap the cuff on bare skin, not over clothing. This is a common mistake seen even in the clinics. A rolled-up sleeve or even just a sleeve that’s tight around your arm can definitely affect your blood pressure reading. To ensure an accurate result, slip your arm out of the sleeve before placing the blood pressure cuff.
WHAT TO DO IF I GET A HIGH BLOOD PRESSURE READING?
One episode of a high blood pressure reading is not an immediate cause for panic. As aforementioned above, it is recommended to take your blood pressure a few more times to ensure its accuracy. If it is still high or higher than normal, then you may consult your physician to seek advice on what can be done or if still in doubt, to verify whether there may be any issues with your current device.
However, if your blood pressure readings are equal to or higher than 180/120 mm Hg, you may wait 5 minutes and then take it again. If your readings are consistently high after re-taking, do not hesitate to contact your doctor immediately. You could be experiencing a hypertensive crisis.
Lastly, if your blood pressure is higher than 180/120 mm Hg AND is accompanied by signs of possible organ damage such as chest pain, shortness of breath, back pain, numbness/weakness, change in vision, difficulty speaking, do NOT test again or wait to see if your pressure comes down on its own! Proceed to the nearest emergency room as soon as possible for immediate medical attention. You may be having a heart attack or a stroke.
Blood pressure monitoring offers many advantages but it’s equally important to know that you are doing it correctly. We hope that the basic information and tips presented in this article help you get the most accurate results possible and ultimately, allow you to take control of your blood pressure.
Remember, though, that measuring your blood pressure at home is NOT a substitute for consultations or clinic visits with your physician. There are many factors to consider with regards to home blood pressure monitoring, most importantly, that it is prone to human error as it takes practice to get it right, and even so, it might not always be correct. Also, never stop or change your medications or even your diet on your own even if you get normal readings without talking to physician first.
Continue monitoring your blood pressure especially if you are hypertensive, whether you do home monitoring or have it taken during regular check-ups, or both, be proud in the fact that you are taking an active role in your health and wellness.
HOW CAN EVA TELECONSULT HELP IN YOUR BLOOD PRESSURE MONITORING JOURNEY?
Here at EVA Teleconsult we have expert doctors like our Primary care physicians and an Internal Medicine doctor who can give you further guidance on how to accurately monitor your blood pressure at home. Furthermore, our doctors are always ready to address any questions or concerns you may have about hypertension or any other related health conditions. Here is how EVA works, at EVA our patients are guaranteed to experience the following:
- Timely appointments – No more time wasted while waiting outside a doctor’s office. With us, appointments begin right when they’re supposed to, even if they’re made the same day.
- Guaranteed 30-minute consultation times – No more rushing or quickly dashed off prescriptions with no explanations. Our doctors take the time needed to give you information about your concerns, and are open to answering all your questions.
- 5-star ratings for our doctors – Because our doctors know how to explain things in a way patients can understand, we frequently get positive feedback from them.
Remember, monitoring your blood pressure at home is not enough to control your blood pressure. Doctors and patients should always work hand in hand in the management of hypertension. So, it’s always best to seek medical advice from a health care professional. Get the health advice you or your loved ones need and book an online consultation today.
About The Author
Dr. Hannah is a highly-skilled and compassionate physician who completed her medical degree at Pamantasan ng Lungsod ng Maynila in 2014. She passed the Physician Licensure Exam in 2015, and has since gained experience working in various hospitals and clinics throughout Metro Manila. For three years, she served as a physician on duty at a dialysis institute, caring for patients with chronic lifestyle diseases.
As a primary care physician, Dr. Hannah is dedicated to providing patient-centered care that takes into account the whole person, not just their illness. She believes in empowering her patients to take an active role in their healthcare, and believes that this type of doctor-patient relationship is key to achieving optimal health.